0
Sign In  | Subscribe
19 June 2012, Vol 156, No. 12>
Summaries for Patients | 19 June 2012

Hospitalization and Delirium in Persons With Alzheimer Disease FREE

[+] Article and Author Information

The full report is titled “Adverse Outcomes After Hospitalization and Delirium in Persons With Alzheimer Disease.” It is in the 19 June 2012 issue of Annals of Internal Medicine (volume 156, pages 848-856). The authors are T.G. Fong, R.N. Jones, E.R. Marcantonio, D. Tommet, A.L. Gross, D. Habtemariam, E. Schmitt, L. Yap, and S.K. Inouye.


Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.

Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.


Ann Intern Med. 2012;156(12):I-20. doi:10.7326/0003-4819-156-12-201206190-00001
Text Size: A A A

What is the problem and what is known about it so far?

Evidence shows that patients with Alzheimer disease (AD) are much more likely to be hospitalized than other older people. If hospitalized, older people often develop delirium, and those with AD are at an even greater risk for this complication. Many clinical observations and small studies have suggested that hospitalization of patients with AD, especially if delirium occurs, causes further cognitive decline, leads to the need for nursing home placement, and increases the risk for death.

Why did the researchers do this particular study?

To directly compare a group of hospitalized patients with AD with similar patients with AD who were not hospitalized to better determine the risk for bad outcomes due to hospitalization and to delirium occurring during hospitalization.

Who was studied?

A large group of community-dwelling older people living in Massachusetts, who receive their clinical care from a specialized research center.

How was the study done?

Data collected directly from patients as part of the study were combined with data from medical records, the Social Security Death Index, and other data sources.

What did the researchers find?

Patients with AD who are hospitalized for any reason are more likely to die than patients with AD who are not hospitalized. If they survive hospitalization, they are more likely to require placement in an institutional facility, such as a nursing home. Of great importance, the occurrence of delirium in patients with AD substantially increased these risks compared with patients with AD who did not develop delirium. The authors estimate that 6% of deaths, 15% of institutionalizations, and 21% of cases of cognitive decline in hospitalized patients with AD can be associated with delirium.

What were the limitations of the study?

Although a study like this cannot prove that delirium directly caused death, institutional-ization, or other bad outcomes, it suggests that this is the case.

What are the implications of the study?

When faced with the decision to hospitalize a loved one with AD, caregivers may want to ask health care providers to carefully consider whether alternatives to hospitalization can be identified. If hospitalization is necessary, then efforts should be made to prevent delirium. Caregivers of patients with AD should realize that hospitalization often marks a substantial downturn in the course of AD, especially if delirium ensues, and should plan for the increased support that their loved ones, and they, may need if it occurs.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general jounals
BMJ 2010;341:c5893-c1494.

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy This Article

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Register Now for a free account
Advertisement

Related Content

Customize your page view by dragging & repositioning the boxes below.

In the Clinic
Delirium
Ann Intern Med. 2011;154(11):ITC6-1.
Topic Collections
PubMed Articles
Delirium and Long-term Cognitive Trajectory Among Persons With Dementia.
Archives of internal medicine Issue date: 2012 Sep 24
[Clinical issues on prescribing psychotropics for elderly patients].
Seishin shinkeigaku zasshi = Psychiatria et neurologia Japonica Issue date: 2012

Annals of Internal Medicine

Other Resources

Copyright © 2013 The American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Buy This Article

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Register Now for a free account
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)