Abstract
Objective
Delirium is an independent risk factor for cognitive impairment and development of
dementia in medical patients. It has never been thoroughly studied whether this association
is also present in the stroke population. Our aim was to evaluate the effects of delirium
in the acute phase after stroke on cognitive functioning two years later.
Methods
Two years after stroke, 50 patients (22 with and 28 without delirium in the acute
phase) were assessed on two screening instruments for dementia and a neuropsychological
test battery.
Results
Delirium was an independent predictor for development of dementia as assessed by the
Clinical Dementia Rating Scale (odds ratio (OR) 4.7; 95% confidence interval (CI)
1.08 to 20.42) and by the Rotterdam-CAMCOG (OR 7.2, 95% CI 1.88 to 27.89). Cognitive
domains most affected in patients with previous delirium were memory, language, visual
construction and executive functioning.
Conclusions
Delirium in the acute phase after stroke is an independent predictor for severe cognitive
impairment two years after stroke. These findings emphasize the importance of both
rapid detection and treatment of delirium after stroke. Furthermore, periodic monitoring
and evaluation of cognitive functioning in these vulnerable patients in the years
after stroke is strongly recommended.
Keywords
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Article info
Publication history
Published online: April 11, 2011
Accepted:
March 9,
2011
Received in revised form:
February 3,
2011
Received:
July 19,
2010
Identification
Copyright
© 2011 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
