Delirium in Older People

A special issue of Geriatrics (ISSN 2308-3417).

Deadline for manuscript submissions: closed (31 January 2021) | Viewed by 3477

Special Issue Editor


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Guest Editor
Faculty of Medicine, University of Coimbra, 3000-270 Coimbra, Portugal
Interests: delirium; depression; cognitive impairment; healthcare service organization

Special Issue Information

Dear Colleagues,

Delirium is a neuropsychiatric syndrome manifesting in a sudden and fluctuating impairment of attention, awareness and cognitive function, and is particularly common in older adults with acute illness. This syndrome affects 10–15% of older patients in the emergency department, up to 30% in general medical wards and 15–25% following elective surgical procedures associated with poor outcomes. The most common triggers of delirium include acute infections, metabolic conditions, iatrogenic complications, surgery, trauma, uncontrolled pain and medications.

The clinical relevance of delirium has led to the development of several guidelines regarding the prevention, recognition, diagnosis and treatment of this syndrome. As delirium remains a major diagnostic challenge, a significant amount of research is being dedicated to developing reliable tools to improve the recognition of this syndrome in clinical practice. At the same time, as a translational perspective is being increasingly used in delirium research, several pathophysiological hypotheses are being tested, incorporating both basic science and clinical research findings. Indeed, the progressive understanding of the fundamental neurobiological processes underlying delirium will allow for a more precise definition and classification of this syndrome, the development of biomarkers enabling the diagnosis at the pre-symptomatic stage, monitoring the clinical evolution and predicting the clinical outcome. Ultimately, this will also have implications for the development of more effective approaches to prevent delirium and slow the progression or retard the clinical manifestations of neurodegenerative disorders.

Dr. Joaquim Cerejeira
Guest Editor

Manuscript Submission Information

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Keywords

  • delirium
  • older people

 

Published Papers (1 paper)

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Research

12 pages, 985 KiB  
Article
Preoperative Cognitive Impairment and Postoperative Delirium Predict Decline in Activities of Daily Living after Cardiac Surgery—A Prospective, Observational Cohort Study
by Ulf Guenther, Falk Hoffmann, Oliver Dewald, Ramy Malek, Kathrin Brimmers, Nils Theuerkauf, Christian Putensen and Julius Popp
Geriatrics 2020, 5(4), 69; https://doi.org/10.3390/geriatrics5040069 - 3 Oct 2020
Cited by 10 | Viewed by 2980
Abstract
Cardiac surgery and subsequent treatment in the intensive care unit (ICU) has been shown to be associated with functional decline, especially in elderly patients. Due to the different assessment tools and assessment periods, it remains yet unclear what parameters determine unfavorable outcomes. This [...] Read more.
Cardiac surgery and subsequent treatment in the intensive care unit (ICU) has been shown to be associated with functional decline, especially in elderly patients. Due to the different assessment tools and assessment periods, it remains yet unclear what parameters determine unfavorable outcomes. This study sought to identify risk factors during the entire perioperative period and focused on the decline in activity of daily living (ADL) half a year after cardiac surgery. Follow-ups of 125 patients were available. It was found that in the majority of patients (60%), the mean ADL declined by 4.9 points (95% CI, −6.4 to −3.5; p < 0.000). In the “No decline” -group, the ADL rose by 3.3 points (2.0 to 4.6; p < 0.001). A multiple regression analysis revealed that preoperative cognitive impairment (MMSE ≤ 26; Exp(B) 2.862 (95%CI, 1.192–6.872); p = 0.019) and duration of postoperative delirium ≥ 2 days (Exp(B) 3.534 (1.094–11.411); p = 0.035) was independently associated with ADL decline half a year after the operation and ICU. Of note, preoperative ADL per se was neither associated with baseline cognitive function nor a risk factor for functional decline. We conclude that the preoperative assessment of cognitive function, rather than functional assessments, should be part of risk stratification when planning complex cardiosurgical procedures. Full article
(This article belongs to the Special Issue Delirium in Older People)
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