Reader Remarks on:

Delirium and Alzheimer Disease: A Dangerous Duo

Report of the Obvious
Reply to Dr. Dobsevage

Report of the Obvious

Tina A Dobsevage, 5 May 2009 9:51 AM EST

Competing interests: None declared

Presumably people with Alzheimer's have a progressive degenerative neurological disease which never improves significantly even with Aricept, etc. Delirium is generally a sign of more severe disease. Any event requiring hospitalization accelerates the functional decline of the elderly with or without dementia. If with dementia, that will be worse as well.

Reply to Dr. Dobsevage

Lisa A Leinau, Cheshire Medical Center/Dartmouth-Hitchcock Keene, 2 Jun 2009 9:44 AM EST

Competing interests: None declared

While pre-existing cognitive impairment is a risk factor for delirium, people without cognitive impairment also become delirious in the context of infection, medications, etc. Delirium is not just a sign of more severe dementia. Also, delirium is sometimes preventable -- as is functional decline. The Hospital Elder Life Program (HELP) has been shown to reduce the incidence of delirium and functional decline in the hospitalized elderly. (http://elderlife.med.yale.edu/public/public- main.php)

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