title: Delirium and cognitive decline: more than a coincidence.
abstract: OBJECTIVE
  To review the recent findings on the relationships between delirium and cognitive decline in the elderly.
  
  
  RESULTS
  Current advances in the field include substantial new evidence that delirium increases the risk of dementia in patients without previous cognitive impairment and accelerates cognitive decline in patients with Alzheimer's disease. Findings on cognitive trajectories and domains affected contribute to better understanding of the clinical nature of cognitive impairment after delirium. Volume loss and disruption of white matter integrity may represent early MRI markers for long-term cognitive impairment. Neurodegenerative and low-level chronic inflammatory processes predispose to exaggerated response to incident stimuli that may precipitate both acute brain dysfunction and persisting cerebral damage.
  
  
  CONCLUSIONS
  Still little is known about the relationship between delirium and cognitive trajectories in the elderly, and the underlying pathophysiological mechanisms. The association of neurodegenerative and inflammatory processes appears to play an important role in the pathogenesis and the clinical course of cognitive impairment after delirium. The hypothetical role of several other factors remains to be clarified. Further clinical studies are needed to evaluate whether prevention and treatment approaches that proved to be useful to reduce delirium incidence and severity may also improve long-term outcomes, and prevent cognitive decline.
authors.affiliation: aDivision of Old Age Psychiatry, Department of Psychiatry bDepartment of Clinical Neuroscience, Leenaards Memory Center, University Hospital of Lausanne, Lausanne, Switzerland.
authors.forename: Julius
authors.initials: J
authors.lastname: Popp
mesh_terms: D000375:Aging; D003072:Cognition Disorders / Q000150:complications* / Q000453:epidemiology*; D003693:Delirium / Q000150:complications* / Q000453:epidemiology*; D006801:Humans