Data_Sheet_1_Impaired Executive Function and Depression as Independent Risk Factors for Reported Delirium Symptoms: An Observational Cohort Study Over 8 Years.docx

BackgroundAcute medical illnesses, surgical interventions, or admissions to hospital in older individuals are frequently associated with a delirium. In this cohort study, we investigated the impact of specific cognitive domains and depression before the occurrence of delirium symptoms in an 8-year observation of older non-hospitalized individuals.
MethodsIn total, we included 807 participants (48–83 years). Deficits in specific cognitive domains were measured using the CERAD test battery, and depressive symptoms were measured using Beck Depression Inventory and the Geriatric Depression Scale (GDS) before the onset of a delirium. Delirium symptoms were retrospectively assessed by a questionnaire based on the established Nursing Delirium Screening Scale.
ResultsFifty-eight of eight hundred seven participants (7.2%) reported delirium symptoms over the 8-year course of the study. Sixty-nine percent (n = 40) of reported delirium symptoms were related to surgeries. In multivariate regression analysis, impaired executive function was an independent risk factor (p = 0.034) for the occurrence of delirium symptoms. Furthermore, age (p = 0.014), comorbidities [captured by the Charlson Comorbidity Index (CCI)] (p < 0.001), and depression (p = 0.012) were significantly associated with reported delirium symptoms.
ConclusionEspecially prior to elective surgery or medical interventions, screening for impaired executive function and depression could be helpful to identify patients who are at risk to develop delirium symptoms.

背景：急性内科疾病、外科手术或老年个体住院治疗常与谵妄发作密切相关。本队列研究针对8年随访期内的非住院老年人群，探讨谵妄症状出现前，特定认知域损害与抑郁症状对谵妄发生的影响。
方法：本研究共纳入807名年龄介于48~83岁的受试者。于谵妄发作前，采用CERAD测试量表（CERAD test battery）评估特定认知域的功能损害，采用贝克抑郁量表（Beck Depression Inventory）与老年抑郁量表（Geriatric Depression Scale, GDS）评估抑郁症状。谵妄症状则基于已确立的护理谵妄筛查量表（Nursing Delirium Screening Scale）设计问卷，进行回顾性评估。
结果：807名受试者中共有58例（7.2%）在8年随访期间出现谵妄症状。其中69%（n=40）的谵妄发作与外科手术相关。多变量回归分析显示，执行功能损害是谵妄症状发生的独立危险因素（p=0.034）。此外，年龄（p=0.014）、合并症（通过查尔森合并症指数（Charlson Comorbidity Index, CCI）评估）（p<0.001）以及抑郁症状（p=0.012）均与报告的谵妄症状存在显著关联。
结论：尤其在择期手术或内科干预前，筛查执行功能损害与抑郁症状，有助于识别谵妄症状的高风险人群。