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)

Hdl Handle:
http://hdl.handle.net/10147/324848
Title:
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)
Authors:
Davis, Daniel HJ; Barnes, Linda E; Stephan, Blossom CM; MacLullich, Alasdair MJ; Meagher, David; Copeland, John; Matthews, Fiona E; Brayne, Carol; on behalf of the MRC Cognitive Function and Ageing Study
Citation:
BMC Geriatrics. 2014 Jul 28;14(1):87
Issue Date:
28-Jul-2014
URI:
http://dx.doi.org/10.1186/1471-2318-14-87; http://hdl.handle.net/10147/324848
Abstract:
Abstract 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.
Language:
en
Keywords:
OLDER PEOPLE; POPULATION HEALTH

Full metadata record

DC FieldValue Language
dc.contributor.authorDavis, Daniel HJen_GB
dc.contributor.authorBarnes, Linda Een_GB
dc.contributor.authorStephan, Blossom CMen_GB
dc.contributor.authorMacLullich, Alasdair MJen_GB
dc.contributor.authorMeagher, Daviden_GB
dc.contributor.authorCopeland, Johnen_GB
dc.contributor.authorMatthews, Fiona Een_GB
dc.contributor.authorBrayne, Carolen_GB
dc.contributor.authoron behalf of the MRC Cognitive Function and Ageing Studyen_GB
dc.date.accessioned2014-08-15T13:00:02Z-
dc.date.available2014-08-15T13:00:02Z-
dc.date.issued2014-07-28-
dc.identifier.citationBMC Geriatrics. 2014 Jul 28;14(1):87en_GB
dc.identifier.urihttp://dx.doi.org/10.1186/1471-2318-14-87-
dc.identifier.urihttp://hdl.handle.net/10147/324848-
dc.description.abstractAbstract 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.-
dc.language.isoenen
dc.subjectOLDER PEOPLEen_GB
dc.subjectPOPULATION HEALTHen_GB
dc.titleThe 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)en_GB
dc.language.rfc3066en-
dc.rights.holderDaniel HJ Davis et al.; licensee BioMed Central Ltd.-
dc.description.statusPeer Reviewed-
dc.date.updated2014-08-08T15:13:28Z-
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