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Semin Neurol 2024; 44(06): 732-751
DOI: 10.1055/s-0044-1791543
Review Article

The Relationship between Delirium and Dementia

Mfon E. Umoh
1   Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
,
Dennis Fitzgerald
2   Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
,
Sarinnapha M. Vasunilashorn
3   Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
4   Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
,
Esther S. Oh
1   Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
,
Tamara G. Fong
2   Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
5   Aging Brain Center, Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts
› Author Affiliations Funding This work was supported by the Health Services and Outcomes Research for Aging Populations Training Program funded by the National Institute on Aging to M.E.U. (grant number T32AG066576), E.S.O. (R01AG076525, R01AG057667, R01AG057725, P30AG073104, P30AG021334), and S.M.V. (K01AG057836, R01AG079864), and the Alzheimer's Association to S.M.V. (grant number AARG-22-917342).
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Abstract

Delirium and dementia are common causes of cognitive impairment in older adults. They are distinct but interrelated. Delirium, an acute confusional state, has been linked to the chronic and progressive loss of cognitive ability seen in dementia. Individuals with dementia are at higher risk for delirium, and delirium itself is a risk factor for incident dementia. Additionally, delirium in individuals with dementia can hasten underlying cognitive decline. In this review, we summarize recent literature linking these conditions, including epidemiological, clinicopathological, neuroimaging, biomarker, and experimental evidence supporting the intersection between these conditions. Strategies for evaluation and diagnosis that focus on distinguishing delirium from dementia in clinical settings and recommendations for delirium prevention interventions for patients with dementia are presented. We also discuss studies that provide evidence that delirium may be a modifiable risk factor for dementia and consider the impact of delirium prevention interventions on long-term outcomes.

Keywords

delirium - dementia - delirium superimposed on dementia - cognitive decline - geriatrics

Note

This review updates search from prior work (Reference: Fong et al 2015, Lancet Review; Fong and Inouye 2022, Nature Rev Neurology).




Publication History

Article published online:
11 October 2024

© 2024. Thieme. All rights reserved.

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