Background: Older hip fracture patients are at high risk of delirium during acute hospital care. Pre-fracture dementia is known to increase the risk of in-hospital delirium. Data on the development of new cognitive disorders in patients with delirium are scarce. Objective: The objective of this study is to evaluate the prognostic significance of in-hospital delirium on the development of new cognitive disorders in a 1-year follow-up in older hip fracture patients. Material and Methods: Data consisted of 476 hip fracture patients aged 65 years or more with no known cognitive disorder on admission. Delirium was assessed using the Confusion Assessment Method (CAM). Cognitive disorders were diagnosed following the national guidelines. Information on the new diagnoses of cognitive disorders (NDCD) at 1-year follow-up was elicited in a telephone interview and confirmed from the electronic patient files. Logistic regression analyses were conducted to examine the association of delirium with NDCDs. Results: Of the 476 patients, 87 (18%) had delirium during hospital stay. Patients with delirium were older, they had poorer nutritional status, lower mobility level, and more supported living arrangements than did patients without delirium. At the 1-year time point, 205 (43%) had NDCDs or were strongly suspected of this. CAM result was statistically significantly associated with development of NDCD in multivariable-adjusted analysis (odds ratio [OR] 2.29; 95% confidence interval [CI]: 1.39–3.79). Also, poor nutritional status continued to be associated with NDCDs (multivariable-adjusted OR 1.58; 95% CI: 1.03–2.43). Conclusion: Delirium during hospitalization and poor nutritional status on admission are independent prognostic factors for development of subsequent cognitive disorders in older hip fracture patients.
Dement Geriatr Cogn Disord

中文翻译：

---

院内谵妄作为髋部骨折后 1 年随访中新认知障碍的预后因素

背景：老年髋部骨折患者在急性住院治疗期间发生谵妄的风险很高。已知骨折前痴呆会增加院内谵妄的风险。关于谵妄患者新的认知障碍发展的数据很少。目的：本研究的目的是评估院内谵妄对老年髋部骨折患者 1 年随访中新认知障碍发展的预后意义。材料与方法：数据包括 476 名年龄在 65 岁或以上的髋部骨折患者，入院时没有已知的认知障碍。使用混淆评估方法 (CAM) 评估谵妄。根据国家指南诊断认知障碍。1 年随访时新诊断的认知障碍 (NDCD) 信息是通过电话采访得出的，并从患者电子档案中得到确认。进行逻辑回归分析以检查谵妄与 NDCD 的关联。结果：在 476 名患者中，87 名 (18%) 在住院期间出现谵妄。与没有谵妄的患者相比，谵妄患者年龄较大，营养状况较差，行动不便，生活安排更受支持。在 1 年时间点，205 人 (43%) 患有 NDCDs 或强烈怀疑患有此病。在多变量调整分析中，CAM 结果与 NDCD 的发展具有统计学显着相关性（优势比 [OR] 2.29；95% 置信区间 [CI]：1.39-3.79）。此外，营养不良仍与 NDCD 相关（多变量调整 OR 1.58；95% CI：1.03–2.43）。结论：住院期间谵妄和入院时营养状况不佳是老年髋部骨折患者后续认知障碍发展的独立预后因素。
老年痴呆症认知障碍