Just give me evidence that dementia and delirium are more than simply associated with each other. One might just as easily (and more convincingly) say dementia is a risk factor for delirium.
Comments
Log in with your Bluesky account to leave a comment
Thanks - will reply properly tomorrow. In brief, maybe 3 types of evidence:
(a) studies looking baseline cognition to rule out existing dementia then showing that people who get delirium are at far higher risk of future dementia
(b) studies showing that people with acute systemic illness have evidence of damage to the brain (e.g. in ICU studies)
(c) animal model studies showing that in prion models peripheral inflammatory stimuli cause both (i) acute cog change, & (ii) accelerated longer-term neurodegeneration
Just not yet sure of why the evidence base is unconvincing to some.
I think it is more about the class of risk factor than the effect size or the plausibility - it is unconventional & doesn't fit readily into standard models of slow damage over time.
The argument is that acute illness can cause acute brain injury leading to (a) delirium & (b) longer-term effects including dementia.
Delirium itself is a product of the injury, not likely a direct cause, but nevertheless when delirium is present the risks of future decline are higher.
Comments
(a) studies looking baseline cognition to rule out existing dementia then showing that people who get delirium are at far higher risk of future dementia
...
(c) animal model studies showing that in prion models peripheral inflammatory stimuli cause both (i) acute cog change, & (ii) accelerated longer-term neurodegeneration
...
Just not yet sure of why the evidence base is unconvincing to some.
I think it is more about the class of risk factor than the effect size or the plausibility - it is unconventional & doesn't fit readily into standard models of slow damage over time.
Delirium itself is a product of the injury, not likely a direct cause, but nevertheless when delirium is present the risks of future decline are higher.