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Delirium is a strong risk factor for dementia in the oldest-old: a population-based cohort study
Davis DH, Muniz Terrera G, Keage H, Rahkonen T, Oinas M, Matthews FE, Cunningham C, Polvikoski T et al.. Brain : a journal of neurology, 2012-08-09
Topic: Risk, prevention and care in population studies
Recent studies suggest that delirium is associated with risk of dementia and also acceleration of decline in existing dementia. Delirium was also associated with worsening dementia severity (odds ratio 3.1, 95% confidence interval 1.5-6.3) as well as deterioration in global function score (odds ratio 2.8, 95% confidence interval 1.4-5.5). In the whole study population, delirium was associated with loss of 1.0 more Mini-Mental State Examination points per year (95% confidence interval 0.11-1.89) than those with no history of delirium. In individuals with dementia and no history of delirium (n = 232), all pathologies were significantly associated with dementia. For example, higher Braak stage was associated with dementia when no history of delirium (odds ratio 2.0, 95% confidence interval 1.1-3.5, P = 0.02), but in those with a history of delirium, there was no significant relationship (odds ratio 1.2, 95% confidence interval 0.2-6.7, P = 0.85). These findings are the first to demonstrate in a true population study that delirium is a strong risk factor for incident dementia and cognitive decline in the oldest-old. However, in this study, the relationship did not appear to be mediated by classical neuropathologies associated with dementia.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Davis, D. H., Muniz Terrera, G., Keage, H., Rahkonen, T., Oinas, M., Matthews, F. E., et al. (2012). Delirium is a strong risk factor for dementia in the oldest-old: a population-based cohort study. Brain : a journal of neurology. https://doi.org/10.1093/brain/aws190
Vancouver
Davis DH, Muniz Terrera G, Keage H, Rahkonen T, Oinas M, Matthews FE, et al. Delirium is a strong risk factor for dementia in the oldest-old: a population-based cohort study. Brain : a journal of neurology. 2012. doi:10.1093/brain/aws190. PMID: 22879644.
BibTeX
@article{davis2012-22879644,
author = {Davis, D. H. and Muniz Terrera, G. and Keage, H. and Rahkonen, T. and Oinas, M. and Matthews, F. E. and Cunningham, C. and Polvikoski, T. and others},
title = {{Delirium is a strong risk factor for dementia in the oldest-old: a population-based cohort study}},
journal = {Brain : a journal of neurology},
year = {2012},
doi = {10.1093/brain/aws190},
pmid = {22879644},
url = {https://doi.org/10.1093/brain/aws190}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
Key findings
- Recent studies suggest that delirium is associated with risk of dementia and also acceleration of decline in existing dementia.
- Delirium was also associated with worsening dementia severity (odds ratio 3.1, 95% confidence interval 1.5-6.3) as well as deterioration in global function score (odds ratio 2.8, 95% confidence interval 1.4-5.5).
- In the whole study population, delirium was associated with loss of 1.0 more Mini-Mental State Examination points per year (95% confidence interval 0.11-1.89) than those with no history of delirium.
- In individuals with dementia and no history of delirium (n = 232), all pathologies were significantly associated with dementia.
- For example, higher Braak stage was associated with dementia when no history of delirium (odds ratio 2.0, 95% confidence interval 1.1-3.5, P = 0.02), but in those with a history of delirium, there was no significant relationship (odds ratio 1.2, 95% confidence interval 0.2-6.7, P = 0.85).
Why it matters
In a population-based study of the oldest-old, people who had had delirium lost about 1 more point per year on the Mini-Mental State Examination than those who had not (95% CI 0.11–1.89), and had higher odds of worsening dementia severity (OR 3.1) and declining everyday function (OR 2.8). The authors describe delirium as "a strong risk factor for incident dementia," but this is an observed association, not proof that delirium causes dementia. Unexpectedly, in people with a history of delirium, dementia was not clearly linked to the usual Alzheimer's-type brain changes such as Braak stage, which suggests delirium may contribute to decline by a different route.
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Study details
- Participants232
- Evidence strengthLow
How this study scored 64/100
Published in a leading specialty journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Brain : a journal of neurology) |
| Journal's citation record | 4 / 4 | Brain: journal h-index 503 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2012 — within 20 year(s) of the newest study here |
| Sample size | 2 / 4 | 232 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 559 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 34.9 citations a year over 16 year(s) since 2012 |
| Impact for its field and year | 5 / 6 | Cited 23.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 35 other studies in this library |
| Still being cited | 3 / 4 | Cited 77 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Carol Brayne: h-index 159 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Cambridge: institution h-index 1,973 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 9 institution(s) in 4 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 22879644) |
| Free to read | 2 / 2 | Free to read |
| Total | 64 / 100 | — |
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