Delirium in elderly hospitalised patients: protective effects of chronic rivastigmine usage

• Published in: International journal of geriatric psychiatry Vol. 19; no. 7; pp. 641 - 644
• Main Authors: Dautzenberg, Paul L. J., Mulder, Leonie J., Olde Rikkert, Marcel G. M., Wouters, Cees J., Loonen, Anton J. M.
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01-07-2004; Wiley; Wiley Subscription Services, Inc
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Carbamates - therapeutic use; Cholinesterase Inhibitors - therapeutic use; delirium; Delirium - prevention & control; Delirium - psychology; Dementia; Drug therapy; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Female; Geriatric psychiatry; Geriatrics; high-risk; Hospitalization; Humans; Male; Medical research; Medical sciences; Mental disorders; Middle Aged; Non tumoral diseases; Older people; Otorhinolaryngology. Stomatology; Phenylcarbamates; prevention; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Retrospective Studies; Risk Factors; Rivastigmine; Netherlands; Human; Delirium; Enzyme; Psychotropic; Enzyme inhibitor; Esterases; Antialzheimer agent; Acetylcholinesterase; Carboxylic ester hydrolases; Organic mental disorder; Chronic; Rivastigmine; Nootropic agent; Hydrolases; Anticholinesterase agent; Elderly; Protection; Geriatrics
• ISSN: 0885-6230; 1099-1166
• DOI: 10.1002/gps.1138

Objectives
To investigate the efficacy of the chronic usage of the cholinesterase inhibitor rivastigmine in patients with dementia in the prevention of delirium in case of hospitalisation.
Design
Retrospective cohort study.
Setting
Non‐geriatric wards of an 1120 bed general teaching hospital in s‐Hertogenbosch, The Netherlands.
Participants
Of a group of 366 hospitalised patients, treated by the geriatric consultation team from January 2002 until June 2003, the patients who used rivastigmine chronically were compared with a randomly selected subgroup of all patients not treated with rivastigmine.
Measurements
The occurrence and duration of a delirium, co‐morbidity, use of medication, length of hospitalisation and psychosocial data were collected from the medical charts of the geriatric consultation team.
Results
11 patients (3%) were chronic rivastigmine users. A control group of 29 subjects was randomly selected from the non‐rivastigmine users of the patient population. In the group that used rivastigmine five patients (45.5%) developed a delirium, compared with 8 (88.9%) in the control group (p < 0.05).
Conclusions
Chronic rivastigmine use may contribute to the prevention of a delirium in a high‐risk group of elderly hospitalised patients suffering from dementia. Copyright © 2004 John Wiley & Sons, Ltd.