Frequent in dementia, deadliest without it: delirium and mortality in hospitalised older adults.
Background Delirium is common in hospitalised older adults and is associated with mortality. Whether this prognostic association varies by baseline cognition is uncertain. We evaluated the association between delirium and 90-day mortality and whether baseline cognitive status modified this relations...
| Publicado en: | Age & Ageing Vol. 55; no. 4; pp. 1 - 11 |
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| Autores principales: | , , , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Apr2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=193500078&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 193500078 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Apr2026 vid: 55 iid: 4 pid: 622 pub: Oxford University Press / USA artinfo: ui: 193500078 10.1093/ageing/afag081 ppf: 1 ppct: 10 formats: tig: atl: Frequent in dementia, deadliest without it: delirium and mortality in hospitalised older adults. aug: au: Umoh, Mfon Avelino-Silva, Thiago J Aliberti, Marlon Juliano Romero Garcez, Flavia Barreto Lee, Sei J Smith, Alexander K Oh, Esther affil: Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21224, USA Division of Geriatrics, Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USALaboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, SP, 05403-000, Brazil Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, SP, 05403-000, BrazilResearch Institute, Hospital Sirio-Libanes, São Paulo, SP, 01308-060, Brazil Division of Geriatrics, Department of Medicine, Universidade Federal de Sergipe Hospital Universitario, Aracaju, SE, 49060-025, Brazil Division of Geriatrics, Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA su: Hospital care Cognition Risk assessment Research funding Hospital mortality Descriptive statistics Longitudinal method Kaplan-Meier estimator Log-rank test Delirium Research Dementia Data analysis software Confidence intervals Sensitivity & specificity (Statistics) sug: subj: Hospital care Cognition Risk assessment Research funding Hospital mortality Descriptive statistics Longitudinal method Kaplan-Meier estimator Log-rank test Delirium Research Dementia Data analysis software Confidence intervals Sensitivity & specificity (Statistics) keyword: copyrightHolder:British Geriatrics Society copyrightYear:2026 delirium dementia effect modification hospitalisation https://dx.doi.org/10.1093/ageing/afag081 inLanguage:en mortality older adult older people prognosis publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/41965247/ copyrightHolder:British Geriatrics Society copyrightYear:2026 delirium dementia effect modification hospitalisation https://dx.doi.org/10.1093/ageing/afag081 inLanguage:en mortality older adult older people prognosis publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/41965247/ ab: Background Delirium is common in hospitalised older adults and is associated with mortality. Whether this prognostic association varies by baseline cognition is uncertain. We evaluated the association between delirium and 90-day mortality and whether baseline cognitive status modified this relationship. Methods We conducted a prospective, multicentre cohort study of adults aged ≥65 years admitted to 43 hospitals in five countries (Brazil, Angola, Chile, Colombia and Portugal; June 2022–December 2023). Delirium was assessed using the Confusion Assessment Method; cognitive status was measured using an informant-based Clinical Dementia Rating (CDR). Mortality within 90 days of admission was ascertained from hospital records, structured telephone follow-up by blinded assessors and registry linkage. We used mixed-effects survival models with random intercepts (state/province and study centre) and sequential adjustment for sociodemographic, clinical and hospital-related factors. Effect modification by CDR was examined with stratified analyses. Results Among 2556 patients (mean age 79 ± 9 years; 56% women), delirium occurred in 957 (37%). Delirium frequency rose with worsening cognition (CDR 0: 16%; CDR 0.5: 27%; CDR 1: 59%; CDR 2–3: 77%; P < .001). Delirium was associated with higher 90-day mortality (adjusted HR = 3.45; 95% CI = 2.83–4.20). The relative association with mortality was greatest in no dementia and attenuated in moderate–severe dementia. At 90 days, cumulative mortality was 54% with delirium vs. 15% without in CDR 0 (HR = 4.40; 95% CI = 3.15–6.16) and 36% vs. 17% in CDR 2–3 (HR = 2.22; 95% CI = 1.34–3.66). Patients with delirium also experienced more in-hospital complications (nosocomial infection, functional decline and prolonged stay). Conclusions Although delirium was more frequent among patients with dementia, its relative association with 90-day mortality was strongest in those with no baseline dementia. The results provide a strong rationale for intervention trials to determine whether delirium prevention and management strategies can reduce mortality, particularly among patients without known dementia. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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