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Delirium in general hospital as a marker of undiagnosed dementia

Delirium in general hospital as a marker of undiagnosed dementia: evaluation of pragmatic methods for screening and follow-up

Dementias (co-adopted by Ageing)
Portfolio Eligibility
Automatically eligible
UKCRN ID 13655
Research Summary
Dementia is common in older inpatients but only half will have a previous diagnosis of dementia. Delirium is a common, severe, inpatient acute neuropsychiatric syndrome. Two-thirds of cases of delirium occur in patients with dementia. Delirium, therefore, provides an opportunity to identify undiagnosed dementia. However, because delirium affects cognition, detecting dementia is problematic. Aims: To determine if, in older hospital in-patients with delirium: (1) There is dementia (2) Simple informant questionnaires can identify dementia To determine if key clinical factors, routine blood tests or putative endocrine or immune biomarkers predict poorer outcomes in patients with delirium. Methods 230 patients aged over 70 years with delirium will be assessed through detailed carer interview for the presence pre-existing DSM-IV dementia (gold standard). This will be compared with (blinded) assessments of dementia using simple, clinically pragmatic informant questionnaires. Key clinical variables and putative prognostic endocrine and immune indicators of prognosis will be measured. Participants will undergo a home visit at 3 months to confirm presence/absence of dementia. Expected Outcomes Validation of informant questionnaires for detection of dementia in delirium will provide a pragmatic method of detecting undiagnosed dementia in general hospitals, potentially benefiting tens of thousands of patients in the UK per year.
Study Type Observational
Design Type Cohort study
Disease(s) Dementia
All Ageing
Phase N/A
Current Status Closed - follow-up complete
Closure Date 11/18/2014
Global Sample Size 124
Global Recruitment to Date
Geographical Scope Single Centre
Lead Country England
Main Inclusion Criteria
All patients over 70 years of age admitted to hospital within the previous 48 hours
Main Exclusion Criteria
Acutely distressed or terminally ill
Inability to communicate due to severe sensory impairment or to communicate in English
Refusing involvement, irrespective of ability to give informed consent
Chief Investigator(s)
Dr Thomas Jackson
Further details, please contact
Dr Thomas Jackson

Queen Elizabeth Hospital
Department of Geriatric Medicine
50G, 5th Floor Nuffield House
Queen Elizabeth Hospital
Queen Elizabeth Medical Centre
West Midlands
B15 2TH

Tel: 07879656362
Funder(s) Age UK
Sponsor(s) University of Birmingham
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