Delirium affects up to half of patients over 65 during their hospital stay. 

Study finding “recurrent delirium over 12 months predicts dementia” wins prestigious prize

A research paper involving the University of Exeter has been awarded the prestigious Dhole-Eddlestone Memorial Prize 2022. The prize is given annually to the most deserving medical research relating to the needs of older people, published over the last year in the scientific journal of the British Geriatrics Society, Age and Ageing.  

The paper Recurrent delirium over 12 months predicts dementia: results of the Delirium and Cognitive Impact in Dementia (DECIDE) study was led by Newcastle University and co-authored by Professor Louise Allan from the University of Exeter’s College of Medicine and Health, with further researchers from University College London and the Universities of Nottingham and Cambridge.

The paper showed for the first time that those patients who experience delirium while in hospital have an increased risk of cognitive decline and of a new diagnosis of dementia. Furthermore, the research proves that the more severe grades of delirium are associated with worse cognitive outcomes.

Delirium is a serious cognitive disorder which affects up to half of patients over 65 years of age during their hospital stay (1). While there has been progress in research, education, and clinical management of delirium, these findings from the DECIDE study offer substantial clinical implications because delirium itself is modifiable, and in some cases preventable (2, 3). Interventions to reduce the risk of delirium may have the potential to reduce the burden of dementia for individuals and therefore wider society.

Professor Louise Allan, from the University of Exeter, said: “We’re delighted that Age and Ageing have recognised this paper which was the result of intensive work and marvellous help from the participants themselves. We believe it has been very important to demonstrate the effects of delirium upon cognition because of the potential to use preventative strategies to avoid this happening. We are looking forward to doing some further work to help people recover from delirium.”

The prize selection committee was impressed by this study which builds on the trajectory of research into delirium and its association with dementia. In 2019, the Age and Ageing journal highlighted the progress and possibilities for the treatment of delirium with its collection Delirium research, education and practice and accompanying commentary from Susan Shenkin and Alastair MacLullich.

Professor Rowan Harwood, Editor-in-Chief of Age and Ageing, commented: “Delirium is common, serious and a distressing experience for many ill older people. But it is still under-researched. This study demonstrated that episodes of delirium can result in permanent cognitive damage. It answered a clinically relevant question, was ambitious, used a very neat design and was brilliantly executed. We had 19 nominations for the prize, all of outstanding academic quality. Age and Ageing, with an impact factor of 10.7, has become the leading international journal in clinical geriatric medicine thanks to papers such as these.”

The paper will be presented, and the Dhole-Eddlestone Memorial Prize awarded, at the virtual BGS Spring Meeting, which is being held online 6-8 April 2022.

Read the full paper Recurrent delirium over 12 months predicts dementia: results of the Delirium and Cognitive Impact in Dementia (DECIDE) study. By Sarah J Richardson, Daniel H J Davis, Blossom C M Stephan, Louise Robinson, Carol Brayne, Linda E Barnes, John-Paul Taylor, Stuart G Parker and Louise M Allan. Published 16th December 2020.

References

1. Inouye SK, Westendorp RGJ, Saczynski JS. Delirium in elderly people. The Lancet2014; 383: 911–22

2. Daniel Davis, Samuel D Searle, Alex Tsui, The Scottish Intercollegiate Guidelines Network: risk reduction and management of delirium, Age and Ageing, Volume 48, Issue 4, July 2019, Pages 485–488,

3. Siddiqi N, Harrison JK, Clegg A et al. Interventions  for preventing delirium in hospitalised non-ICU patients. Cochrane Database Syst Rev 2016.

Date: 14 January 2022