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    The Incidence of Recorded Delirium Episodes Before and After Dementia Diagnosis: Differences Between Dementia With Lewy Bodies and Alzheimer's Disease

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    URI
    https://rde.dspace-express.com/handle/11287/621699
    Author
    Ballard, Clive
    Date
    2019-05
    Journal
    Journal of the American Medical Directors Association
    Type
    Journal Article
    Publisher
    Elsevier Science
    DOI
    10.1016/j.jamda.2018.09.021
    Rights
    © 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
    Metadata
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    Abstract
    Objectives: To describe the incidence of delirium recording before and after a diagnosis of dementia is established in patients with dementia with Lewy bodies (DLB) and compare findings to a matched cohort of patients with Alzheimer's disease (AD). Design: Retrospective cohort study. Setting and participants: A cohort of patients with dementia from a large mental health and dementia care database in South London, linked to hospitalization and mortality data. We identified 194 patients with DLB and 1:4 matched these with 776 patients diagnosed with AD on age, gender, and cognitive status. Measures: We identified delirium episodes recorded in mental health and hospital records from 1 year before to 1 year after dementia diagnosis. Using dementia diagnosis as an index date we additionally followed patients until first episode of delirium, death or a censoring point without restricting the observation period. Results: Patients with DLB had significantly more episodes of delirium recorded in the year before dementia diagnosis than patients with AD (incidence rate 17.6 vs 3.2 per 100 person-years; P < .001). Whereas the incidence of recording of delirium episodes reduced substantially in patients with DLB after dementia diagnosis, it remained significantly higher than in patients with AD (incidence rate 6.2 vs 2.3 per 100 person-years; P = .032). Cox regression models indicate that patients with DLB remain at a higher risk of delirium than patients with AD after a dementia diagnosis. Conclusions/relevance: Establishing a diagnosis of dementia reduces episodes classified as delirium in patients with DLB and might lead to fewer potentially harmful interventions such as hospitalization or use of antipsychotic medication.
    Citation
    FitzGerald JM et al. The Incidence of Recorded Delirium Episodes Before and After Dementia Diagnosis: Differences Between Dementia With Lewy Bodies and Alzheimer's Disease. J Am Med Dir Assoc. 2019 May;20(5):604-609. doi: 10.1016/j.jamda.2018.09.021. Epub 2018 Nov 15.
    Publisher URL
    https://linkinghub.elsevier.com/retrieve/pii/S1525-8610(18)30532-2
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    • Healthcare for Older People
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