BMC Geriatrics | |
The descriptive epidemiology of delirium symptoms in a large population-based cohort study: results from the Medical Research Council Cognitive Function and Ageing Study (MRC CFAS) | |
Carol Brayne7  Fiona E Matthews6  John Copeland2  David Meagher4  Alasdair MJ MacLullich3  Blossom CM Stephan1  Linda E Barnes7  Daniel HJ Davis5  | |
[1] Institute of Health and Society, Newcastle University, Newcastle, UK;Department of Psychiatry, University of Liverpool, Liverpool, UK;University of Edinburgh Centre for Cognitive Ageing and Cognitive Epidemiology, Edinburgh, UK;Graduate Entry Medical School, University of Limerick, Limerick, Ireland;MRC Unit for Lifelong Health and Ageing, University College London, 33 Bedford Place, London WC1B 5JU, UK;MRC Biostatistics Unit, Cambridge, UK;Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK | |
关键词: Algorithm diagnosis; Epidemiology; Population; Dementia; Delirium; | |
Others : 1090128 DOI : 10.1186/1471-2318-14-87 |
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received in 2013-11-14, accepted in 2014-07-14, 发布年份 2014 | |
【 摘 要 】
Background
In the general population, the epidemiological relationships between delirium and adverse outcomes are not well defined. The aims of this study were to: (1) construct an algorithm for the diagnosis of delirium using the Geriatric Mental State (GMS) examination; (2) test the criterion validity of this algorithm against mortality and dementia risk; (3) report the age-specific prevalence of delirium as determined by this algorithm.
Methods
Participant and informant data in a randomly weighted subsample of the Cognitive Function and Ageing Study were taken from a standardized assessment battery. The algorithmic definition of delirium was based on the DSM-IV classification. Outcomes were: proportional hazard ratios for death; odds ratios of dementia at 2-year follow-up.
Results
Data from 2197 persons (representative of 13,004) were used, median age 77 years, 64% women. Study-defined delirium was associated with a new dementia diagnosis at two years (OR 8.82, 95% CI 2.76 to 28.2) and death (HR 1.28, 95% CI 1.03 to 1.60), even after adjustment for acute illness severity. Similar associations were seen for study-defined subsyndromal delirium. Age-specific prevalence as determined by the algorithm increased with age from 1.8% in the 65-69 year age group to 10.1% in the ≥85 age group (p < 0.01 for trend). For study-defined subsyndromal delirium, age-specific period prevalence ranged from 8.2% (65-69 years) to 36.1% (≥85 years).
Conclusions
These results demonstrate the possibility of constructing an algorithmic diagnosis for study-defined delirium using data from the GMS schedule, with predictive criterion validity for mortality and dementia risk. These are the first population-based analyses able to account prospectively for both illness severity and an earlier study diagnosis of dementia.
【 授权许可】
2014 Davis et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
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20150128154348496.pdf | 265KB | download | |
Figure 2. | 44KB | Image | download |
Figure 1. | 39KB | Image | download |
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Figure 2.
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