Skip to main content Accessibility help
×
Home
Hostname: page-component-684899dbb8-5dd2w Total loading time: 0.26 Render date: 2022-05-19T23:07:01.169Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true }

Delirium, depression, and long-term cognition

Published online by Cambridge University Press:  12 November 2021

Patricia S. Andrews*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA Center for Cognitive Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
Jennifer Thompson
Affiliation:
Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
Rameela Raman
Affiliation:
Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA
Chelsea Rick
Affiliation:
Department of Medicine, Division of Geriatric Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
Amy Kiehl
Affiliation:
Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA Department of Medicine, Division of Pulmonary and Critical Care, Vanderbilt University Medical Center, Nashville, Tennessee, USA
Pratik Pandharipande
Affiliation:
Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA Department of Anesthesiology, Division of Anesthesiology Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
James C. Jackson
Affiliation:
Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA Department of Medicine, Division of Pulmonary and Critical Care, Vanderbilt University Medical Center, Nashville, Tennessee, USA Veteran’s Affairs TN Valley, Geriatrics Research, Education and Clinical Center, Nashville, Tennessee, USA
Warren D. Taylor
Affiliation:
Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA Center for Cognitive Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA Veteran’s Affairs TN Valley, Geriatrics Research, Education and Clinical Center, Nashville, Tennessee, USA
E. W. Ely
Affiliation:
Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA Department of Medicine, Division of Pulmonary and Critical Care, Vanderbilt University Medical Center, Nashville, Tennessee, USA Veteran’s Affairs TN Valley, Geriatrics Research, Education and Clinical Center, Nashville, Tennessee, USA
Jo E. Wilson
Affiliation:
Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA Veteran’s Affairs TN Valley, Geriatrics Research, Education and Clinical Center, Nashville, Tennessee, USA
*
Correspondence should be addressed to: Patricia S. Andrews, Department of Psychiatry and Behavioral Sciences, The Vanderbilt Psychiatric Hospital, 1601 23rd Avenue South, Nashville, TN 37212, USA. Phone: +(615) 936-3555; Fax: +(615) 875-0686. Email: patricia.andrews@vumc.org

Abstract

Objectives:

We examined whether preadmission history of depression is associated with less delirium/coma-free (DCF) days, worse 1-year depression severity and cognitive impairment.

Design and measurements:

A health proxy reported history of depression. Separate models examined the effect of preadmission history of depression on: (a) intensive care unit (ICU) course, measured as DCF days; (b) depression symptom severity at 3 and 12 months, measured by the Beck Depression Inventory-II (BDI-II); and (c) cognitive performance at 3 and 12 months, measured by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) global score.

Setting and participants:

Patients admitted to the medical/surgical ICU services were eligible.

Results:

Of 821 subjects eligible at enrollment, 261 (33%) had preadmission history of depression. After adjusting for covariates, preadmission history of depression was not associated with less DCF days (OR 0.78, 95% CI, 0.59–1.03 p = 0.077). A prior history of depression was associated with higher BDI-II scores at 3 and 12 months (3 months OR 2.15, 95% CI, 1.42–3.24 p = <0.001; 12 months OR 1.89, 95% CI, 1.24–2.87 p = 0.003). We did not observe an association between preadmission history of depression and cognitive performance at either 3 or 12 months (3 months beta coefficient −0.04, 95% CI, −2.70–2.62 p = 0.97; 12 months 1.5, 95% CI, −1.26–4.26 p = 0.28).

Conclusion:

Patients with a depression history prior to ICU stay exhibit a greater severity of depressive symptoms in the year after hospitalization.

Type
Original Research Article
Copyright
© International Psychogeriatric Association, 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Albert, K. M., Potter, G. G., McQuoid, D. R. and Taylor, W. D. (2018). Cognitive performance in antidepressant-free recurrent major depressive disorder. Depression and Anxiety, 35, 694699.CrossRefGoogle ScholarPubMed
Barnes, D. E., Alexopoulos, G. S., Lopez, O. L., Williamson, J. D. and Yaffe, K. (2006). Depressive symptoms, vascular disease, and mild cognitive impairment: findings from the Cardiovascular Health Study. Archives of General Psychiatry, 63, 273279.CrossRefGoogle ScholarPubMed
Bienvenu, O. J. et al. (2015). Cooccurrence of and remission from general anxiety, depression, and posttraumatic stress disorder symptoms after acute lung injury: a 2-year longitudinal study. Critical Care Medicine, 43, 642653.CrossRefGoogle ScholarPubMed
Bonito, A. J., Bann, C., Eicheldinger, C. and Carpenter, L. (2008). Creation of New Race-Ethnicity Codes and Socioeconomic Status (SES) Indicators for Medicare Beneficiaries. Rockville, MD: Agency for Healthcare Research and Quality.Google Scholar
Brummel, N. E. et al. (2014). Delirium in the ICU and subsequent long-term disability among survivors of mechanical ventilation. Critical Care Medicine, 42, 369377.CrossRefGoogle ScholarPubMed
Davis, D. H. et al. (2012). Delirium is a strong risk factor for dementia in the oldest-old: a population-based cohort study. Brain, 135, 28092816.CrossRefGoogle ScholarPubMed
Davydow, D. S., Gifford, J. M., Desai, S. V., Bienvenu, O. J. and Needham, D. M. (2009). Depression in general intensive care unit survivors: a systematic review. Intensive Care Medicine, 35, 796809.CrossRefGoogle ScholarPubMed
Diniz, B. S., Butters, M. A., Albert, S. M., Dew, M. A. and Reynolds, C. F. (2013). Late-life depression and risk of vascular dementia and Alzheimer’s disease: systematic review and meta-analysis of community-based cohort studies. British Journal of Psychiatry, 202, 329335.CrossRefGoogle ScholarPubMed
Ely, E. W. et al. (2001). Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Critical Care Medicine, 29, 13701379.CrossRefGoogle Scholar
Gleason, L. J. et al. (2015). Effect of delirium and other major complications on outcomes after elective surgery in older adults. JAMA Surgery, 150, 11341140.CrossRefGoogle ScholarPubMed
Goldberg, T. E. et al. (2020). Association of delirium with long-term cognitive decline: a meta-analysis. JAMA Neurology, 77, 19.CrossRefGoogle ScholarPubMed
Greaves, D. et al. (2020). Risk factors for delirium and cognitive decline following coronary artery bypass grafting surgery: a systematic review and meta-analysis. Journal of the American Heart Association, 9, e017275.CrossRefGoogle ScholarPubMed
Hatch, R., Young, D., Barber, V., Griffiths, J., Harrison, D. A. and Watkinson, P. (2018). Anxiety, depression and post traumatic stress disorder after critical illness: a UK-wide prospective cohort study. Critical Care, 22, 310.CrossRefGoogle ScholarPubMed
Jackson, J. C., et al. (2014). Depression, post-traumatic stress disorder, and functional disability in survivors of critical illness in the BRAIN-ICU study: a longitudinal cohort study. The Lancet Respiratory Medicine, 2, 369379.CrossRefGoogle ScholarPubMed
Lawrence, C., Roy, A., Harikrishnan, V., Yu, S. and Dabbous, O. (2013). Association between severity of depression and self-perceived cognitive difficulties among full-time employees. Primary Care Companion for CNS Disorders, 15, 12m01469.Google ScholarPubMed
Murrough, J. W., Iacoviello, B., Neumeister, A., Charney, D. S. and Iosifescu, D. V. (2011). Cognitive dysfunction in depression: neurocircuitry and new therapeutic strategies. Neurobiology of Learning and Memory, 96, 553563.CrossRefGoogle ScholarPubMed
Needham, D. M. et al. (2012). Improving long-term outcomes after discharge from intensive care unit: report from a stakeholders' conference. Critical Care Medicine, 40, 502509.CrossRefGoogle ScholarPubMed
Nordness, M. F. et al. (2021). Depression predicts long-term cognitive impairment in survivors of critical illness. Journal of Trauma and Acute Care Surgery, 90, 7986.CrossRefGoogle ScholarPubMed
Oldham, M. A. et al. (2019). Depression predicts delirium after coronary artery bypass graft surgery independent of cognitive impairment and cerebrovascular disease: an analysis of the neuropsychiatric outcomes after heart surgery study. The American Journal of Geriatric Psychiatry, 27, 476486.CrossRefGoogle ScholarPubMed
Pandharipande, P. P. et al. (2014). Long-term cognitive impairment after critical illness. The New England Journal of Medicine, 370, 185186.Google ScholarPubMed
Pandharipande, P. P. et al. (2013). Long-term cognitive impairment after critical illness. The New England Journal of Medicine, 369, 13061316.CrossRefGoogle ScholarPubMed
Rabiee, A. et al. (2016). Depressive symptoms after critical illness: a systematic review and meta-analysis. Critical Care Medicine, 44, 17441753.CrossRefGoogle ScholarPubMed
Saczynski, J. S. et al. (2010). Depressive symptoms and risk of dementia: the Framingham Heart Study. Neurology, 75, 3541.CrossRefGoogle ScholarPubMed
Sakuramoto, H., Subrina, J., Unoki, T., Mizutani, T. and Komatsu, H. (2015). Severity of delirium in the ICU is associated with short term cognitive impairment. A prospective cohort study. Intensive and Critical Care Nursing, 31, 250257.CrossRefGoogle ScholarPubMed
Wang, S., Allen, D., Kheir, Y. N., Campbell, N. and Khan, B. (2018). Aging and post-intensive care syndrome: a critical need for geriatric psychiatry. The American Journal of Geriatric Psychiatry, 26, 212221.CrossRefGoogle ScholarPubMed
Wang, S. et al. (2017). Post-intensive care unit psychiatric comorbidity and quality of life. Journal of Hospital Medicine, 12, 831835.CrossRefGoogle ScholarPubMed

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Delirium, depression, and long-term cognition
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Delirium, depression, and long-term cognition
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Delirium, depression, and long-term cognition
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *