Department of Medical Psychology and Neuropsychology, CoRPS-Center of Research on Psychology in Somatic diseases, Tilburg University, The Netherlands.
J Neurol Sci. 2011 Jul 15;306(1-2):138-42. doi: 10.1016/j.jns.2011.03.024. Epub 2011 Apr 9.
Delirium is an independent risk factor for cognitive impairment and development of dementia in medical patients. It has never been thoroughly studied whether this association is also present in the stroke population. Our aim was to evaluate the effects of delirium in the acute phase after stroke on cognitive functioning two years later.
Two years after stroke, 50 patients (22 with and 28 without delirium in the acute phase) were assessed on two screening instruments for dementia and a neuropsychological test battery.
Delirium was an independent predictor for development of dementia as assessed by the Clinical Dementia Rating Scale (odds ratio (OR) 4.7; 95% confidence interval (CI) 1.08 to 20.42) and by the Rotterdam-CAMCOG (OR 7.2, 95% CI 1.88 to 27.89). Cognitive domains most affected in patients with previous delirium were memory, language, visual construction and executive functioning.
Delirium in the acute phase after stroke is an independent predictor for severe cognitive impairment two years after stroke. These findings emphasize the importance of both rapid detection and treatment of delirium after stroke. Furthermore, periodic monitoring and evaluation of cognitive functioning in these vulnerable patients in the years after stroke is strongly recommended.
谵妄是导致住院患者认知障碍和痴呆的独立危险因素。但目前尚未全面研究这种关联是否也存在于脑卒中人群中。我们的目的是评估脑卒中后急性期谵妄对 2 年后认知功能的影响。
脑卒中后 2 年，对 50 例患者（急性期有谵妄 22 例，无谵妄 28 例）进行了两种痴呆筛查工具和神经心理学成套测验的评估。
经临床痴呆评定量表（优势比（OR）4.7；95%置信区间（CI）1.08 至 20.42）和鹿特丹认知功能成套测验（OR 7.2，95%CI 1.88 至 27.89）评估，谵妄是痴呆发展的独立预测因子。有既往谵妄的患者认知障碍主要表现在记忆、语言、视空间结构和执行功能。
脑卒中后急性期谵妄是脑卒中后 2 年严重认知障碍的独立预测因子。这些发现强调了脑卒中后快速检测和治疗谵妄的重要性。此外，强烈建议对这些易发生谵妄的患者在脑卒中后数年进行定期监测和认知功能评估。
