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谵妄与认知衰退之间的关联:实证文献综述

The association between delirium and cognitive decline: a review of the empirical literature.

作者信息

Jackson James C, Gordon Sharon M, Hart Robert P, Hopkins Ramona O, Ely E Wesley

机构信息

Division of Allergy/Pulmonary/Critical Care Medicine, Center for Health Services Research, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-8300, USA.

出版信息

Neuropsychol Rev. 2004 Jun;14(2):87-98. doi: 10.1023/b:nerv.0000028080.39602.17.

Abstract

Delirium is a common neurobehavioral syndrome that occurs across health care settings which is associated with adverse outcomes, including death. There are limited data on long-term cognitive outcomes following delirium. This report reviews the literature regarding relationships between delirium and cognitive impairment. Psych Info and Medline searches and investigation of secondary references for all English language articles on delirium and subsequent cognitive impairment were carried out. Nine papers met inclusion criteria and documented cognitive impairment in patients following delirium. Four papers reported greater cognitive impairment among patients with delirium than matched controls. Four papers reported higher incidence of dementia in patients with a history of delirium. One study found 1 of 3 survivors of critical illness with delirium developed cognitive impairment. The evidence suggests a relationship between delirium and cognitive impairment, although significant questions remain regarding the nature of this association. Additional research on delirium-related effects on long-term cognitive outcome is needed.

摘要

谵妄是一种常见的神经行为综合征,在各类医疗环境中均有发生,且与包括死亡在内的不良后果相关。关于谵妄后的长期认知结局的数据有限。本报告回顾了有关谵妄与认知障碍之间关系的文献。通过对Psych Info和Medline数据库进行检索,并对所有关于谵妄及后续认知障碍的英文文章的参考文献进行调查。有九篇论文符合纳入标准,并记录了谵妄患者的认知障碍情况。四篇论文报告称,谵妄患者的认知障碍比匹配的对照组更严重。四篇论文报告称,有谵妄病史的患者患痴呆症的发生率更高。一项研究发现,3名患有谵妄的危重病幸存者中有1人出现了认知障碍。有证据表明谵妄与认知障碍之间存在关联,尽管关于这种关联的性质仍存在重大疑问。需要对谵妄对长期认知结局的相关影响进行更多研究。

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