Alzheimer's, Dementia & Mental Health
Hospitalized Seniors with Dementia Have 25 Percent
Chance of Death if Delirium Develops
Most seniors with dementia will develop delirium when
hospitalized, which leads to rapid health decline - many die within 30
Sept. 16, 2013 – More than half of all senior
citizens with pre-existing dementia will experience delirium while
hospitalized. Failing to detect and treat their delirium early leads to
a faster decline of both their physical and mental health, according to
a study supported by the National Institute of Aging.
"This study is important, as delirium is often
overlooked and minimized in the hospital setting, especially in persons
with dementia," said Donna M. Fick, Distinguished Professor of Nursing
at Penn State and principal investigator for this study. "And it
illustrates that delirium is deadly, costly and impacts patient
The researchers followed 139 hospitalized adults,
ages 65 and older, with dementia and found that the patients who
developed delirium had a 25 percent chance of dying within 30 days, as
reported in the current issue of the Journal of Hospital Medicine.
Dementia is an irreversible,
progressive condition that affects cognitive and physical function.
Symptoms usually occur over months to years and can include memory loss,
inability to solve simple problems, difficulties with language and
thinking, personality and behavior changes and other mental problems.
Delirium, on the other hand, is a
reversible cognitive condition that comes on quickly and if caught and
treated early can be resolved. Many of the symptoms of delirium may
appear similar to dementia, but signs such as marked inattention and
sleepiness or hyperactivity can help differentiate delirium from
Fick and colleagues focused on this combination of
disorders, known as delirium superimposed on dementia (DSD), in
The researchers found a 32 percent incidence of new
delirium in the hospitalized patients with dementia. These patients
stayed in the hospital about four days longer than patients without
delirium, and also had a reduced level of physical and mental ability
when they left the hospital and at follow-up visits one month later.
Additionally, patients with DSD were more likely to
have died a month after their hospital stay.
Previous studies have found the cost of delirious
episodes rivals those for diabetes and heart disease. Decreasing the
length of stay by just one day would save more than $20 million in
health care costs per year.
Common causes of delirium are infections,
dehydration and medication changes. A third of the patients in this
study arrived at the hospital dehydrated.
"Preventing delirium is important because we want
to discharge patients at their baseline or improved functioning," said
Fick. "We do not want them to go home with worse functioning than when
they came into the hospital."
The goal of the researchers is to help
practitioners recognize and treat delirium in patients with DSD as early
as possible, helping to improve quality of life for the patient.
The research team included Fick, currently a
2013-2014 visiting scientist at the Institute for Aging Research at
Hebrew SeniorLife in Boston, an affiliate of Harvard Medical School;
Melinda R. Steis, community health coordinator, Orlando Veterans Affairs
Medical Center; Jennifer L. Waller, associate professor of
biostatistics, Georgia Regents University, Augusta, Ga.; and Sharon K.
Inouye, professor of medicine, Harvard Medical School.
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