The Epidemiology of Delirium: A Paper from 2013

Delirium

There is an interesting paper on Delirium from 2013 by Davis et al titled ‘The Epidemiology of Delirium: Challenges and Opportunities for Population Studies’. In the first section of the paper the authors look at the problems faced in epidemiological research. The issues here are particularly relevant to epidemiological researchers but also hold some interest in the interpretation of epidemiological studies or meta-analyses/systematic reviews. A key point in the discussion looked at how results were interpreted – were subjects with complete data included only (with associated bias) or was there an attempt to anticipate data for missing subjects (e.g using random effects modelling).

What I found quite interesting about the paper is the later section which reviews some of the epidemiological studies. The Gerontological Database research study revealed some very useful data about prevalence in people over the age of 85. Age was strongly linked to the prevalence of Delirium in this study which used DSM-IV criteria. The prevalence of Delirium in the 85-89 year age group was 19% compared to 39% in the 95+ age group. The only drawback was that the confidence interval data was missing and it wasn’t clear if this was point or 1-month period prevalence as reported for other data from the study. Regardless, the original study would merit further attention as if this pattern is replicated there is likely to be an important biological link (e.g blood-brain barrier integrity etc) that could be further investigated. The other point is whether there is comorbid Dementia. Nevertheless this does not escape the fact that there is Delirium regardless of whether it is a comorbidity.

The final section looks at the issue of improving epidemiological studies and the methodology here has some overlap with approaches with the potential to improve clinical practice.

Index: There are indices for the TAWOP site here and here Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link. Podcast: You can listen to this post on Odiogo by clicking on this link (there may be a small delay between publishing of the blog article and the availability of the podcast). It is available for a limited period. TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link. Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk. Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog. Conflicts of Interest: For potential conflicts of interest please see the About section.

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