Home › Research › Clinical safety
Frequent in dementia, deadliest without it: delirium and mortality in hospitalised older adults
Mfon E. Umoh, Thiago Junqueira Avelino‐Silva, Márlon Juliano Romero Aliberti, Flávia Barreto Garcez, Sei J Lee, Alexander K Smith, Esther Oh. Age and Ageing, 2026-03-20
Topic: Risk, prevention and care in population studies
Among 2556 patients (mean age 79 ± 9 years; 56% women), delirium occurred in 957 (37%). Delirium frequency rose with worsening cognition (CDR 0: 16%; CDR 0.5: 27%; CDR 1: 59%; CDR 2-3: 77%; P < .001). Delirium was associated with higher 90-day mortality (adjusted HR = 3.45; 95% CI = 2.83-4.20). The relative association with mortality was greatest in no dementia and attenuated in moderate-severe dementia. At 90 days, cumulative mortality was 54% with delirium vs. 15% without in CDR 0 (HR = 4.40; 95% CI = 3.15-6.16) and 36% vs. 17% in CDR 2-3 (HR = 2.22; 95% CI = 1.34-3.66). Patients with delirium also experienced more in-hospital complications (nosocomial infection, functional decline and prolonged stay). Although delirium was more frequent among patients with dementia, its relative association with 90-day mortality was strongest in those with no baseline dementia. The results provide a strong rationale for intervention trials to determine whether delirium prevention and management strategies can reduce mortality, particularly among patients without known dementia.
Key findings
- Among 2556 patients (mean age 79 ± 9 years; 56% women), delirium occurred in 957 (37%).
- Delirium frequency rose with worsening cognition (CDR 0: 16%; CDR 0.5: 27%; CDR 1: 59%; CDR 2-3: 77%; P < .001).
- Delirium was associated with higher 90-day mortality (adjusted HR = 3.45; 95% CI = 2.83-4.20).
- The relative association with mortality was greatest in no dementia and attenuated in moderate-severe dementia.
- At 90 days, cumulative mortality was 54% with delirium vs. 15% without in CDR 0 (HR = 4.40; 95% CI = 3.15-6.16) and 36% vs. 17% in CDR 2-3 (HR = 2.22; 95% CI = 1.34-3.66).
Why it matters
In this cohort of 2556 hospitalized older adults, delirium occurred in 37% and was associated with higher 90-day mortality, with the relative association strongest in those with no baseline dementia. The authors say the results provide a rationale for intervention trials to determine whether delirium prevention and management can reduce mortality, particularly among patients without known dementia.
Study details
- Study designcohort study
- Participants2,556
- Effect sizeHR = 3.45; HR = 4.40; HR = 2.22
- Evidence strengthModerate
How this study scored 65/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 62 of the 96 points we could judge it on, which is 65 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Age and Ageing) |
| Journal's citation record | 2 / 4 | Age and Ageing: journal h-index 231 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 3 / 4 | 2,556 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| 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 | 2 / 7 | Cited 6 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 3.0 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 5 / 6 | Cited 33.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 1 / 4 | Cited 6 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | OpenAlex's profile for last-listed author Esther Oh holds only 4 work(s), too few to judge a track record — left out of this score |
| Institution's track record | 2 / 3 | Johns Hopkins University: institution h-index 2,306 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 7 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41965247) |
| Free to read | 2 / 2 | Free to read |
| Points | 62 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 62 of the 96 points we could judge it on is 65 out of 100. |
| Total | 65 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
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 names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Umoh, M. E., Avelino‐Silva, T. J., Aliberti, M. J. R., Garcez, F. B., Lee, S. J., Smith, A. K., et al. (2026). Frequent in dementia, deadliest without it: delirium and mortality in hospitalised older adults. Age and Ageing. https://doi.org/10.1093/ageing/afag081
Vancouver
Umoh ME, Avelino‐Silva TJ, Aliberti MJR, Garcez FB, Lee SJ, Smith AK, et al. Frequent in dementia, deadliest without it: delirium and mortality in hospitalised older adults. Age and Ageing. 2026. doi:10.1093/ageing/afag081. PMID: 41965247.
BibTeX
@article{umoh2026-41965247,
author = {Umoh, Mfon E. and Avelino‐Silva, Thiago Junqueira and Aliberti, Márlon Juliano Romero and Garcez, Flávia Barreto and Lee, Sei J and Smith, Alexander K and Oh, Esther},
title = {{Frequent in dementia, deadliest without it: delirium and mortality in hospitalised older adults}},
journal = {Age and Ageing},
year = {2026},
doi = {10.1093/ageing/afag081},
pmid = {41965247},
url = {https://doi.org/10.1093/ageing/afag081}
}
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.
Later studies that cite this one
1 study in the alzhub library lists this one in its references.
Related studies in Clinical safety
Also tagged “delirium”
858 studies in the library carry the topic tag “delirium”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 858 tagged studies.