Older people and their families or caretakers often worry about the onset of dementia and what might contribute to its diagnosis. Some conditions clearly contribute to a diagnosis: alcoholism and stroke, for instance. Other contributing illnesses are less clear, until now.
New research shows that infection or severe sepsis, neurological dysfunction, such as delirium, and acute dialysis are all independently associated with an increased risk of dementia.
Almost 18% diagnosed with dementia within three years
This study was based on a random 5 percent of Medicare patients aged 66 years or older treated in intensive care in 2005 and whose health was tracked for a further three years using Medicare claims data. For the 25,368 people who participated in the study, 4,519 or 17.8 percent, subsequently received a diagnosis of dementia within the next three years.
Factors associated with diagnosis
Increasing age certainly contributed to the diagnosis following treatment in an ICU. The risk at 75 years old was double that of the 66- to 69-year-olds. Risk increased more than five times for those aged 85 and older. Risk was higher for women. Length of stay in ICU had no impact.
Three health conditions associated with risk
Three health conditions independently associated with an increased risk of dementia were:
- A critical illness with the presence of an infection
- An acute neurologic dysfunction during a critical illness such as anoxic brain damage, encephalopathy, and transient mental disorders
- Acute renal failure requiring dialysis
Acute renal failure had more specificity with increased risk occurring only six months after discharge from the hospital.
Understanding the consequences of hospitalization for seniors
“Due to increasing life spans and better hospital care, millions of older people now survive a critical illness every year,” said lead author of the study Dr. Hannah Wunsch of Columbia University Medical Center. “Our study provides a greater understanding of the consequences of these hospitalizations on subsequent risk of receiving a diagnosis of dementia, and may allow for better planning and targeting future studies to high risk populations.”
Sources: MedicalNewsToday, Critical Care
