Post-stroke delirium in relation to dementia and long-term mortality
Version of Record online: 10 MAY 2011
Copyright © 2011 John Wiley & Sons, Ltd.
International Journal of Geriatric Psychiatry
Volume 27, Issue 4, pages 401–408, April 2012
How to Cite
Melkas, S., Laurila, J. V., Vataja, R., Oksala, N., Jokinen, H., Pohjasvaara, T., Leppävuori, A., Kaste, M., Karhunen, P. J. and Erkinjuntti, T. (2012), Post-stroke delirium in relation to dementia and long-term mortality. Int. J. Geriat. Psychiatry, 27: 401–408. doi: 10.1002/gps.2733
- Issue online: 8 MAR 2012
- Version of Record online: 10 MAY 2011
- Manuscript Accepted: 22 MAR 2011
- Manuscript Received: 24 JAN 2011
- Clinical Research Institute, Helsinki University Central Hospital
- Medical Research Fund of the Helsinki University Central Hospital
- ischemic stroke;
Delirium is a frequent post-stroke complication that compromises effective rehabilitation and has been associated with poor outcome. We aimed to investigate whether delirium is associated with increased risk of post-stroke dementia and long-term mortality once confounding is taken into account.
The study comprised 263 consecutive acute ischemic stroke patients aged 55–85 years admitted to the emergency department of a university hospital. The cohort included three-month survivors followed up for 10 years. The diagnosis of post-stroke delirium during the first 7 days after stroke was based on the DSM-IV criteria.
Of all the patients, 50 (19.0%) were diagnosed with delirium. Low education, pre-stroke cognitive decline, and severe stroke indicated by a Modified Rankin score between 3 and 5 were risk factors for post-stroke delirium, which was also associated with diagnosis of dementia at 3 months post-stroke. In the Kaplan–Meier analysis, delirium was associated with poor long-term survival (6.1 versus 9.1 years). In the stepwise Cox regression proportional hazards analysis adjusted for demographic factors and risk factors, advanced age (hazard ratio [HR] 1.08) and stroke severity (HR 1.83), but not post-stroke delirium, were associated with poor survival.
In our well-defined cohort of post-stroke patients, acute stage delirium was diagnosed in one in five patients and associated with dementia at 3 months. Advanced age and stroke severity were related to the higher long-term mortality among patients with post-stroke delirium. Copyright © 2011 John Wiley & Sons, Ltd.