title: Delirium in acute stroke: a predictor of subsequent cognitive impairment? A two-year follow-up study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medical Psychology and Neuropsychology, CoRPS-Center of Research on Psychology in Somatic diseases, Tilburg University, The Netherlands. m.w.a.vanrijsbergen@uvt.nl
authors.forename: Marielle W A
authors.initials: MW
authors.lastname: van Rijsbergen
authors.forename: Annemarie W
authors.initials: AW
authors.lastname: Oldenbeuving
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Nieuwenhuis-Mark
authors.forename: Gudrun M S
authors.initials: GM
authors.lastname: Nys
authors.forename: Sylvia G M
authors.initials: SG
authors.lastname: Las
authors.forename: Gerwin
authors.initials: G
authors.lastname: Roks
authors.forename: Paul L M
authors.initials: PL
authors.lastname: de Kort
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001288:Attention / Q000502:physiology; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D003693:Delirium / Q000150:complications* / Q000209:etiology*; D056344:Executive Function / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007802:Language; D007858:Learning / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D020521:Stroke / Q000150:complications*; D014796:Visual Perception / Q000502:physiology