Cognitive, Functional, and Mortality Outcomes of Attenuated Delirium Syndrome in Stroke Survivors.

Journal: Journal of geriatric psychiatry and neurology

Volume: 34

Issue: 6

Year of Publication: 2021

Affiliated Institutions:  Department of Psychiatry, World Health Organization (WHO) Collaborating Centre for Research and Training in Mental health, Neuroscience, and Substance abuse, College of Medicine, University of Ibadan, Ibadan, Nigeria. Division of Neurology, Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria. Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria.

Abstract summary 

There is a knowledge gap on the prognostic significance of subsyndromes of delirium. We describe the association of poststroke attenuated delirium syndrome (ADS) with cognitive, functional, and mortality outcomes at 3 months.A longitudinal observational study in which repeated assessments for delirium symptoms were conducted in the first week of stroke using the confusion assessment method. Attenuated delirium syndrome was characterized in survivors who were free of the full delirium syndrome but had ≥2 core features of delirium. Baseline and follow-up assessments were conducted using the Mini-Mental State Examination (MMSE), 10-word list learning and delayed recall test, Animal naming test, and Barthel index.Among 150 participants recruited consecutively over 2 years, ADS was present in 32 (21.3%). Of 121 who were free of the full delirium syndrome, 21 (17.4%) had died by 3 months. Those who survived were more likely to be receiving treatment for systemic hypertension (88.5%, = .007). In analyses adjusting for the effect of age, economic status, and systemic hypertension, ADS in the first week of stroke predicted cognitive decline at 3 months ([mean difference (MD) in MMSE scores = -3.8, 95% CI = -7.0 to -0.7, = .019]). However, ADS was not associated with greater decline in activities of daily life (MD = -0.4, 95% CI = -2.8 to 2.0) or significant odds ratio (OR) of mortality (OR = 2.3, 95% CI = 0.8-6.3).Attenuated delirium syndrome may be an important marker of cognitive impairment at 3 months poststroke. Its detection may lead to identification of stroke survivors who are likely to benefit from evidence-based preventive interventions for poststroke cognitive decline.

Authors & Co-authors:  Ojagbemi Akin A Bello Toyin T Owolabi Mayowa M Baiyewu Olusegun O

Study Outcome 

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Statistics
Citations : 
Authors :  4
Identifiers
Doi : 10.1177/0891988720944234
SSN : 0891-9887
Study Population
Male,Female
Mesh Terms
Cognition
Other Terms
DSM-V;neurocognitive disorders;poststroke delirium;poststroke disability;poststroke mortality;subsyndromal delirium
Study Design
Longitudinal Study,Cross Sectional Study
Study Approach
Systemic Review
Country of Study
Publication Country
United States