Delirium in elderly hospitalised patients: protective effects of chronic rivastigmine usage
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‐He...
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| Published in: | International journal of geriatric psychiatry Vol. 19; no. 7; pp. 641 - 644 |
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| Main Authors: | , , , , |
| Format: | Journal Article |
| Language: | English |
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Chichester, UK
John Wiley & Sons, Ltd
01-07-2004
Wiley Wiley Subscription Services, Inc |
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| Abstract | 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. |
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| AbstractList | 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.
Retrospective cohort study.
Non-geriatric wards of an 1120 bed general teaching hospital in s-Hertogenbosch, The Netherlands.
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.
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.
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).
Chronic rivastigmine use may contribute to the prevention of a delirium in a high-risk group of elderly hospitalised patients suffering from dementia. 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 hospitalization. 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 hospitalized 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 hospitalization 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 hospitalized patients suffering from dementia. [PUBLICATION ABSTRACT] Abstract 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. 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. OBJECTIVESTo 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.DESIGNRetrospective cohort study.SETTINGNon-geriatric wards of an 1120 bed general teaching hospital in s-Hertogenbosch, The Netherlands.PARTICIPANTSOf 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.MEASUREMENTSThe 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.RESULTS11 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).CONCLUSIONSChronic rivastigmine use may contribute to the prevention of a delirium in a high-risk group of elderly hospitalised patients suffering from dementia. 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. |
| Author | Mulder, Leonie J. Loonen, Anton J. M. Dautzenberg, Paul L. J. Olde Rikkert, Marcel G. M. Wouters, Cees J. |
| Author_xml | – sequence: 1 givenname: Paul L. J. surname: Dautzenberg fullname: Dautzenberg, Paul L. J. email: p.dautzenberg@jbz.nl organization: Department Geriatrics Jeroen Bosch Ziekenhuis, s-Hertogenbosch, The Netherlands – sequence: 2 givenname: Leonie J. surname: Mulder fullname: Mulder, Leonie J. organization: Department Geriatrics Jeroen Bosch Ziekenhuis, s-Hertogenbosch, The Netherlands – sequence: 3 givenname: Marcel G. M. surname: Olde Rikkert fullname: Olde Rikkert, Marcel G. M. organization: Department of Geriatrics, University Medical Centre Nijmegen, The Netherlands – sequence: 4 givenname: Cees J. surname: Wouters fullname: Wouters, Cees J. organization: Department Geriatrics Jeroen Bosch Ziekenhuis, s-Hertogenbosch, The Netherlands – sequence: 5 givenname: Anton J. M. surname: Loonen fullname: Loonen, Anton J. M. organization: Department of Clinical Pharmacology, DeltaBouman Psychiatric Hospital, Poortugaal, The Netherlands |
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| Keywords | 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 |
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| References_xml | – volume: 54 start-page: 239 year: 1999 end-page: 246 article-title: Neural mechanisms of delirium: current hypotheses and evolving concepts publication-title: J Gerontol A Biol Sci Med Sci – volume: 11 start-page: 159 year: 1998 end-page: 161 article-title: Donepezil improves symptoms of delirium in dementia: implications for future research publication-title: J Geriatr Psychiatry Neurol – volume: 58A start-page: M441 year: 2003 end-page: M445 article-title: Delirium among newly admitted postacute facility patients: prevalence, symptoms and severity publication-title: J Gerontology – volume: 40 start-page: 601 year: 1992 end-page: 606 article-title: Prognosis after hospital discharge of older medical patients with delirium publication-title: J Am Geriatr Soc – year: 2004 article-title: Adding rivastigmine to antipsychotics in the treatment of a chronic delirium publication-title: Age Ageing – volume: 11 start-page: 138 year: 1998 end-page: 145 article-title: Pathophysiology of delirium publication-title: J Geriatr Psychiatr Neurol – volume: 39 start-page: 422 year: 1998 end-page: 430 article-title: Olanzapine in the treatment of delirium publication-title: Psychosomatics – volume: 13 start-page: 234 year: 1998 end-page: 242 article-title: Does delirium contribute to poor hospital outcomes? A three‐site epidemiologic study publication-title: J Gen Intern Med – volume: 152 start-page: 334 year: 1992 end-page: 340 article-title: An empirical study of delirim publication-title: Br J Psychiatry – volume: 325 start-page: 644 year: 2002 end-page: 647 article-title: ABC of psychological medicine. Delirium publication-title: BMJ – volume: 66 start-page: 137 year: 1999 end-page: 147 article-title: The cholinergic hypothesis of Alzheimer's disease: a review of progress publication-title: J Neurol Neurosurg Psychiatry – volume: 5 start-page: 149 year: 2000 end-page: 153 article-title: Serum anticholinergic activity levels and delirium in the elderly publication-title: Seminars in Clinical Neuropsychiatry – volume: 1 start-page: 24 year: 1997 end-page: 26 article-title: Treatment of delirium with risperidone publication-title: Int J Geriatr Psychopharmacol – volume: 21 start-page: 118 year: 2001 article-title: Successful treatment of nonanticholinergic delirium with a cholinesterase inhibitor publication-title: J Clin Psychopharmacol – volume: 50 start-page: 1723 year: 2002 end-page: 1732 article-title: Delirium superimposed on dementia: a systematic review publication-title: J Am Geriatri Soc – volume: 322 start-page: 144 year: 2001 end-page: 149 article-title: Delirium: optimising management publication-title: BMJ – volume: 161 start-page: 1099 year: 2001 end-page: 1105 article-title: Use of medications with anticholinergic effects predicts clinical severity of delirium symptoms in older medical patients publication-title: Arch Intern Med – volume: 18 start-page: 555 year: 2003 end-page: 558 article-title: Rivastigmine in prevention of delirium in a 65‐years old man with Parkinson's disease publication-title: Int J Geriatr Psychiatry – ident: e_1_2_1_5_1 doi: 10.1046/j.1532-5415.2002.50468.x – volume: 152 start-page: 334 year: 1992 ident: e_1_2_1_13_1 article-title: An empirical study of delirim publication-title: Br J Psychiatry contributor: fullname: Liptzin B – ident: e_1_2_1_2_1 doi: 10.1136/bmj.325.7365.644 – ident: e_1_2_1_11_1 doi: 10.1046/j.1525-1497.1998.00073.x – ident: e_1_2_1_14_1 doi: 10.1177/089198879801100304 – volume: 5 start-page: 149 year: 2000 ident: e_1_2_1_18_1 article-title: Serum anticholinergic activity levels and delirium in the elderly publication-title: Seminars in Clinical Neuropsychiatry contributor: fullname: Tune E – ident: e_1_2_1_4_1 doi: 10.1093/ageing/afh125 – ident: e_1_2_1_15_1 doi: 10.1136/bmj.322.7279.144 – ident: e_1_2_1_19_1 doi: 10.1177/089198879801100308 – ident: e_1_2_1_6_1 doi: 10.1097/00004714-200102000-00026 – ident: e_1_2_1_7_1 doi: 10.1093/gerona/54.6.B239 – ident: e_1_2_1_10_1 doi: 10.1001/archinte.161.8.1099 – ident: e_1_2_1_17_1 doi: 10.1016/S0033-3182(98)71301-5 – volume: 58 start-page: M441 year: 2003 ident: e_1_2_1_12_1 article-title: Delirium among newly admitted postacute facility patients: prevalence, symptoms and severity publication-title: J Gerontology contributor: fullname: Kiely DK – ident: e_1_2_1_9_1 doi: 10.1136/jnnp.66.2.137 – ident: e_1_2_1_3_1 doi: 10.1002/gps.867 – ident: e_1_2_1_8_1 doi: 10.1111/j.1532-5415.1992.tb02111.x – volume: 1 start-page: 24 year: 1997 ident: e_1_2_1_16_1 article-title: Treatment of delirium with risperidone publication-title: Int J Geriatr Psychopharmacol contributor: fullname: Sipahimalani A |
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To investigate the efficacy of the chronic usage of the cholinesterase inhibitor rivastigmine in patients with dementia in the prevention of... To investigate the efficacy of the chronic usage of the cholinesterase inhibitor rivastigmine in patients with dementia in the prevention of delirium in case... Abstract Objectives To investigate the efficacy of the chronic usage of the cholinesterase inhibitor rivastigmine in patients with dementia in the prevention... Objectives: To investigate the efficacy of the chronic usage of the cholinesterase inhibitor rivastigmine in patients with dementia in the prevention of... Objectives To investigate the efficacy of the chronic usage of the cholinesterase inhibitor rivastigmine in patients with dementia in the prevention of... OBJECTIVESTo investigate the efficacy of the chronic usage of the cholinesterase inhibitor rivastigmine in patients with dementia in the prevention of delirium... |
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| SubjectTerms | 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 |
| Title | Delirium in elderly hospitalised patients: protective effects of chronic rivastigmine usage |
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