It is not uncommon for hospital patients to become disoriented and confused. Nearly a quarter of older patients can be affected by this phenomenon and now a new study by UCL and the University of Cambridge shows this condition may have devastating long-lasting implications for those patients, including studied acceleration of the onset of dementia.

Dementia is a category of brain illness that causes an often gradual and long-term decrease in the ability to think and remember. This condition is severe enough to affect daily lifestyle. Some regular symptoms include difficulties with language, emotional problems and a decrease in motivation.

A dementia diagnosis involves detection of change from a person’s usual mental effectiveness and a noticeable decline that is more significant than one would expect due to aging.

Study and data reference

Published in the medical journal JAMA Psychiatry, the study is the original paper to identify the impact of delirium on dementia on these fragile at-risk patients. Episodes of recorded delirium in patients who have never previously shown signs of dementia may prove to be an early warning indicator of dementia

Cognitive decline amongst older patients can be hastened by both dementia and delirium. Delirium, however, is both treatable and preventable through specialised geriatric care.

While additional research into how dementia interacts with delirium is needed, there may be the potential to understand how this transition can be prevented.

Evaluating clinical data

As Dr. Daniel Davis from MRC Unit UCL (Lifelong Health and Ageing), who directed research at the University of Cambridge explained his work as follows: When delirium is responsible for brain damage in the long-term as well as short and, and so we must improve our efforts to study, diagnose, prevent and finally treat delirium. Finally, targeting delirium may be an opportunity to delay or reduce the impact of dementia.

In the study, researchers used a sample of in 987 brain specimens in people 65 years and older drawn from three European countries: Finland, Cambridge, and the United Kingdom. Each individual’s memory, thinking, and experience of delirium had been painstakingly documented 10 years or more towards the end of their lifespan. After cross-correlating this data together with pathology irregularities caused by various dementia types such as Alzheimer’s, those with patients exhibiting both dementia-related and delirium changes had the most significant change in brain function and memory performance.

What can we do?

Dr Davis also stressed that unfortunately, majority of delirium goes unacknowledged or unrecognised. At a busy hospital, a sudden change in behaviour such as confusion is very rarely noticed by care and medical hospital staff. Patients may be transferred a number of times within the hospital facility. Additionally, it is common for staff to often switch, move and change shifts.

To improve detection, it requires all care and medical staff to consider delirium to understand that their patient’s brain has shifted its function, possibly quite subtly in the environment.

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