Prognostic significance of delirium in frail older people

Our aim was to investigate the long-term prognosis of delirium in the frailest elderly, and to clarify whether delirium is just a marker of the underlying severe disease. We used logistic regression analysis to determine the independent prognostic significance of delirium. A representative sample of 425 patients (greater than or equal to70 years) in acute geriatric wards and nursing homes were assessed at baseline and followed up for 2 years. DSM-IV was used for classification. The prevalence of delirium at baseline was 24.9% (106/425). The prognosis of delirium was poor: mortality at 1 year was 34.9 vs. 21.6% in nondelirious subjects ( p = 0.006), and at 2 years 58.5 vs. 42.6% ( p = 0.005). Among home-dwelling people at baseline, 54.4% of the delirious vs. 27.9% of others were permanently institutionalized within 2 years ( p < 0.001). In logistic regression analysis, delirium was an independent predictor for mortality at 1 year ( OR 1.86, 95% CI 1.1 - 3.1), at 2 years ( OR 1.76, 95% CI 1.1 - 2.8), and for permanent institutionalization ( OR 2.45, 95% CI 1.2 - 4.9). Delirious patients with prior dementia tended to have a better prognosis than those without. Copyright (C) 2005 S. Karger AG, Basel.