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The Link Between In-Hospital Delirium and Dementia

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Delirium commonly strikes after surgery, when patients are woozy from the lingering effects of anesthesia and pain medication. Johns Hopkins' specialist, Dr. Michele Bellantoni provides practical advice on minimizing in-hospital delirium.

The connection between delirium and dementia is still not fully understood, although doctors have known for quite some time that people who experience an episode of delirium and recover are more likely to go on to develop dementia.

Delirium may set off a cascade into Alzheimer’s in people who are already at risk. And there is some evidence that this risk may go both ways: People at higher risk for Alzheimer’s may be at greater risk for delirium. Another study published in the Journal of Gerontology found that patients who had the APOE susceptibility gene for Alzheimer’s, but were not diagnosed with Alzheimer’s were more likely to experience in-hospital delirium. That said, because people who develop delirium tend to be older and have coexisting health problems that increase their risk of developing both dementia and delirium, it’s difficult to tease out the direct role, if any, that delirium plays in dementia.

What you can do -- Family members can help minimize or prevent delirium by making sure that a loved one is not left alone for long periods, especially when he or she is coming out of anesthesia. “Often the patient who is waking up after surgery may not know where he or she is, which can be very frightening, so simply knowing that family is close by is a major consolation,” says Dr. Michele Bellantoni, Associate Professor of Medicine at Johns Hopkins.

You may want to arrange to stay overnight at the hospital -- this way someone who knows how the patient normally acts can quickly alert hospital staff to any changes in behavior. “Family members know the patient best, so they can keep doctors and nurses posted if a loved one’s behavior becomes uncharacteristic. It’s a huge help if someone says, ‘You know, this isn’t my mother’s normal behavior.’”

Making sure that the hospital room is well lit and that curtains are regularly drawn during the day can help patients maintain a sense of time and get back to a regular schedule of sleeping at night and staying awake during the day. Family members also can make sure that eyeglasses and hearing aids are worn. And familiar objects from home such as a favorite sweater, blanket, pillow, books, or family photos can also help patients maintain orientation and awareness while they are in the hospital.

Posted in Memory on August 18, 2008


Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer


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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or Remedy Health Media, LLC, which has no responsibility for any comments posted on this site.


My husband had a surgery on his shoulder and came home the same day. At that time he showed signs of loss of memory on the way home. He got out of the car and walked south of the driveway, our gate and house are on the north. After that, everything seemed to go down hill in the memory department. I've always suspected that the anesthesia had somehow effected his mind. Thank you for confirming my suspections. The surgery was done in the later part of 2005; and now in 2010, he isn't able to be left alone and needs help with the most basic of things.

Posted by: dementiawife | January 28, 2010 5:05 AM

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