Does cognitive decline/dementia increase Delirium risk after stroke?

Area of Science:

• Neurology
• Gerontology
• Public Health

Background:

• Delirium is a frequent cause of mortality and increased hospital costs in stroke patients.
• Existing research on the link between cognitive decline/dementia and post-stroke delirium yields inconsistent findings.
• This meta-analysis aims to clarify the association between cognitive decline/dementia and delirium risk after acute stroke.

Purpose of the Study:

• To determine if cognitive decline or dementia is associated with an increased risk of delirium in patients who have experienced an acute stroke.
• To synthesize evidence from multiple observational studies to provide a robust estimate of this association.

Main Methods:

• A systematic literature search was conducted across PubMed, Embase, Google Scholar, and Web of Science up to September 2020.
• Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using fixed or random effects models.
• Study heterogeneity was assessed using the I-squared (I²) index.

Main Results:

• The meta-analysis included 13 studies with 3183 participants, examining the link between cognitive decline/dementia and post-stroke delirium.
• Cognitive decline/dementia was significantly associated with a higher susceptibility to delirium in post-stroke patients (OR = 3.70, 95% CI: 2.90-4.71, P < 0.001).
• Subgroup analyses confirmed this association across different ethnicities, sample sizes, and study publication periods.

Conclusions:

• A significant association exists between cognitive decline/dementia and the risk of developing delirium after stroke.
• Cognitive decline/dementia emerges as a potential predictive marker for delirium in the post-stroke population.