Post-stroke delirium in relation to dementia and long-term mortality

Area of Science:

• Neurology
• Geriatrics
• Critical Care Medicine

Background:

• Delirium is a common complication following stroke, negatively impacting rehabilitation and patient outcomes.
• Understanding the long-term consequences of post-stroke delirium is crucial for improving patient care.

Purpose of the Study:

• To investigate the association between post-stroke delirium and the risk of developing post-stroke dementia.
• To determine if delirium increases long-term mortality after stroke, accounting for confounding factors.

Main Methods:

• A cohort of 263 acute ischemic stroke patients (aged 55-85) was followed for 10 years.
• Post-stroke delirium was diagnosed within 7 days using DSM-IV criteria.
• Outcomes included dementia diagnosis at 3 months and long-term survival.

Main Results:

• 19% of patients experienced post-stroke delirium.
• Delirium was associated with dementia at 3 months post-stroke.
• While delirium correlated with poorer survival in initial analysis, adjusted Cox regression identified advanced age and stroke severity as independent predictors of mortality.

Conclusions:

• Acute delirium affects approximately 20% of post-stroke patients and is linked to 3-month dementia diagnosis.
• Long-term mortality in patients with post-stroke delirium is primarily driven by advanced age and stroke severity, not delirium directly.