Johns Hopkins Health Alert
The Link Between In-Hospital Delirium and Dementia
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 Alzheimers in people who are already at risk. And there is some evidence that this risk may go both ways: People at higher risk for Alzheimers 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 Alzheimers, but were not diagnosed with Alzheimers 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, its 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 ones behavior becomes uncharacteristic. Its a huge help if someone says, You know, this isnt my mothers 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
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