Fitter individuals are at the highest risk of death associated with delirium

Melanie Dani is a trainee in geriatric medicine in the North West Thames deanery. She is also completing a PhD at Imperial College London studying biomarkers in Alzheimer’s Disease, and has an interest in cognition and dementia.

It is well-recognised that delirium is associated with increased mortality. It’s less clear, though, whether this is the case across the spectrum of frailty. There is an idea that delirium might have bimodal outcomes – worse in frailer people, but may be protective in fitter individuals by highlighting an underlying problem early and (potentially) prompting earlier treatment.

While past studies have accounted for chronic diseases and acute illness severity, few have accounted for both. We wanted to see whether the associations of delirium with mortality remained so even after accounting for acute and chronic health factors, so we modelled both these together in a frailty index. This included 31 variables encompassing chronic disease, acute illness parameters, and functional status and was applied in a large cohort of acute medical older inpatients. Continue reading

Cognitive impairment, mortality and discharge from an acute hospital

Carole Fogg is a Senior Lecturer at the University of Portsmouth/Portsmouth Hospitals Trust, (UK). She is a PhD Fellow under the Wessex Collaboration for Leadership in Applied Healthcare and Research, exploring hospital care and outcomes for patients with cognitive impairment and dementia. Her paper “The relationship between cognitive impairment, mortality and discharge characteristics in a large cohort of older adults with unscheduled admissions to an acute hospital: a retrospective observational study has recently been published in Age and Ageing. She tweets at @Carole_Fogg 

When older people with dementia are admitted to hospital, they are more likely to die or to stay in hospital longer than people without dementia. Many older people have cognitive impairment (CI) (problems with memory and thinking) which is a main feature of dementia, but have not yet been given a diagnosis, or may have CI due to other medical conditions. We investigated how common cognitive impairment is in older patients in hospital, and what the risks are for these patients of staying longer or dying in hospital. Continue reading

High blood pressure in old age: revisiting the concept “the lower, the better”

aaGiulia Ogliari is a geriatrician and PhD Candidate at Milan University (Italy) / Leiden University Medical Center (NL). In this blog, she introduces her recent Age & Ageing paper on blood pressure and mortality risk in geriatric outpatients in Milan.

‘’What is my blood pressure, doctor?’’ Everyone, old or young, is curious to know what their blood pressure is. And everyone is convinced that the lower their blood pressure is, the better it is. Yet, this may not be the case for the older adults.

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Report from the 2015 EDA / BGS Delirium conference

BGS Logo CMYKAlice Verran is a second year Foundation doctor at Croydon University Hospital; in this blog she reports back from the recent BGS / EDA meeting on delirium.

A conference jointly hosted by the European Delirium Association and the British Geriatric Society; the perfect union of experts and professionals with an interest in delirium. Not just discussions about delirium in the elderly, but a host of talks on delirium in other contexts such as children in ITU and alcohol withdrawal.

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July issue of Age and Ageing out now

The July issue of Age and Ageing, the journal of the British Geriatrics Society is out now.

A full table of contents is available here, with editorials, research papers, reviews, short reports, case reports book reviews and more. Hot topics this issue include:

  • Use and abuse of bed rails
  • Management of spasticity
  • Mortality in the oldest old
  • Changes in the incidence of age-related disorders
  • HIV infection in older people

The Editor’s Pick can be read here.

This issue’s freely accessible papers are: