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Delirium, Dementia, and Decline

Delirium, Dementia, and Decline Opinion EDITORIAL Tamara G. Fong, MD, PhD; Sharon K. Inouye, MD, MPH; Richard N. Jones, ScD Delirium and dementia are common causes of cognitive im- differences at baseline (6 years before death) and the pace of pairment in older populations. Although each may occur in- mental status decline is independent of neuropathologic find- dependently, delirium and dementia frequently coexist. ings (at death). The effects of delirium and neuropathologic Dementia is a leading risk factor for delirium, and there is findings on mental status performance and pace of decline are an increased incidence of not completely independent, with only partial mediation of new dementia and cognitive delirium effects by pathologic findings and a modification of Related article page 244 decline after delirium. De- their effects when delirium and pathologic findings co-occur. lirium can accelerate the rate Although this study has several noteworthy strengths, in- of cognitive decline, suggesting that an episode of delirium can cluding harmonization of the data into EClipSE, length of result in a more rapid progression of dementia symptoms, lead- follow-up, and large sample size, it also has a number of im- ing to earlier functional disability, increased caregiver bur- portant limitations. First, individual studies, such as http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Psychiatry American Medical Association

Delirium, Dementia, and Decline

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References (9)

Publisher
American Medical Association
Copyright
Copyright 2017 American Medical Association. All Rights Reserved.
ISSN
2168-622X
eISSN
2168-6238
DOI
10.1001/jamapsychiatry.2016.3812
Publisher site
See Article on Publisher Site

Abstract

Opinion EDITORIAL Tamara G. Fong, MD, PhD; Sharon K. Inouye, MD, MPH; Richard N. Jones, ScD Delirium and dementia are common causes of cognitive im- differences at baseline (6 years before death) and the pace of pairment in older populations. Although each may occur in- mental status decline is independent of neuropathologic find- dependently, delirium and dementia frequently coexist. ings (at death). The effects of delirium and neuropathologic Dementia is a leading risk factor for delirium, and there is findings on mental status performance and pace of decline are an increased incidence of not completely independent, with only partial mediation of new dementia and cognitive delirium effects by pathologic findings and a modification of Related article page 244 decline after delirium. De- their effects when delirium and pathologic findings co-occur. lirium can accelerate the rate Although this study has several noteworthy strengths, in- of cognitive decline, suggesting that an episode of delirium can cluding harmonization of the data into EClipSE, length of result in a more rapid progression of dementia symptoms, lead- follow-up, and large sample size, it also has a number of im- ing to earlier functional disability, increased caregiver bur- portant limitations. First, individual studies, such as

Journal

JAMA PsychiatryAmerican Medical Association

Published: Mar 18, 2017

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