Prognostic Significance of Delirium in Frail Older PeoplePitkala K.H. · Laurila J.V. · Strandberg T.E. · Tilvis R.S.
aDepartment of Medicine, Geriatric Clinic, Helsinki University Hospital, and bThe Central Union for the Welfare of the Aged, Helsinki, Finland
Our aim was to investigate the long-term prognosis of delirium in the frailest elderly, and to clarify whether delirium is just a marker of the underlying severe disease. We used logistic regression analysis to determine the independent prognostic significance of delirium. A representative sample of 425 patients (≥70 years) in acute geriatric wards and nursing homes were assessed at baseline and followed up for 2 years. DSM-IV was used for classification. The prevalence of delirium at baseline was 24.9% (106/425). The prognosis of delirium was poor: mortality at 1 year was 34.9 vs. 21.6% in nondelirious subjects (p = 0.006), and at 2 years 58.5 vs. 42.6% (p = 0.005). Among home-dwelling people at baseline, 54.4% of the delirious vs. 27.9% of others were permanently institutionalized within 2 years (p < 0.001). In logistic regression analysis, delirium was an independent predictor for mortality at 1 year (OR 1.86, 95% CI 1.1–3.1), at 2 years (OR 1.76, 95% CI 1.1–2.8), and for permanent institutionalization (OR 2.45, 95% CI 1.2–4.9). Delirious patients with prior dementia tended to have a better prognosis than those without.
Kaisu H. Pitkala, MD, PhD
The Central Union for the Welfare of the Aged
Helsinki University Hospital, Department of Medicine, Geriatric Clinic
PO Box 340, FI–00029 HUS, Helsinki (Finland)
Tel. +358 9 471 74578, Fax +358 9 471 74013, E-Mail firstname.lastname@example.org
Accepted: June 28, 2004
Published online: December 23, 2004
Number of Print Pages : 6
Number of Figures : 0, Number of Tables : 4, Number of References : 30
Dementia and Geriatric Cognitive Disorders
Vol. 19, No. 2-3, Year 2005 (Cover Date: Released February 2005)
Journal Editor: V. Chan-Palay, New York, N.Y.
ISSN: 1420–8008 (print), 1421–9824 (Online)
For additional information: http://www.karger.com/dem