Assessing neurocognitive outcomes after critical illness: are delirium and long-term cognitive impairments related?
OBJECTIVE
Critically ill patients have a high risk of developing neurologic dysfunction including delirium and long-term cognitive impairment. In this paper we examine possible relationships between delirium and long-term cognitive impairments and explore this in the context of critical illness.


RESULTS
Critical illness and its treatment can lead to neurologic morbidity including neuropathological abnormalities, delirium, and cognitive impairments. The association between delirium and long-term cognitive impairments has been shown in a number of populations. Among intensive care unit cohorts, delirium appears to be one of many possible causes of cognitive impairments and may be a leading modifiable cause. The mechanisms of both delirium and intensive care unit related cognitive impairment remain unclear, although a variety of common mechanisms have been proposed.


CONCLUSIONS
Potential neurologic consequences of critical illness include delirium and long-term cognitive impairments. Defining the extent of their association in intensive care unit cohorts is an important research priority due to the high prevalence of delirium and persistent cognitive impairments in critically ill patients. Future research should focus on strategies for the early identification of delirium and cognitive impairments, elucidating mechanisms of brain injury, and the development and implementation of therapeutic modalities designed to prevent or decrease delirium and cognitive morbidity.
Hopkins
Ramona O
RO
Psychology Department and Neuroscience Center, Brigham Young University, Provo, USA. Ramona.Hopkins@intermountainmail.org
Jackson
James C
JC
D003072:Cognition Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control; D016638:Critical Illness / Q000523:psychology* / Q000534:rehabilitation; D003693:Delirium / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D007362:Intensive Care Units; D009017:Morbidity; D011859:Radiography