Change search
ReferencesLink to record
Permanent link

Direct link
Delirium as a predictor of physical and cognitive function in individuals aged 80 and older after transcatheter aortic valve implantation or surgical aortic valve replacement
Department of Clinical Science, University of Bergen, Bergen, Norway.
Department of Clinical Science, University of Bergen, Bergen, Norway.
Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
Department of Clinical Science, University of Bergen, Bergen, Norway.
Show others and affiliations
2016 (English)In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 64, no 6, 1178-1186 p.Article in journal (Refereed) PublishedText
Abstract [en]

Objectives: To determine how development of delirium after surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI) could predict activity of daily living (ADL) and instrumental ADLs (IADL) disability, cognitive function, and self-reported health in individuals aged 80 and older.

Design: Prospective cohort study. Setting: Tertiary university hospital.

Participants: Individuals aged 80 and older undergoing elective SAVR or TAVI (N = 136).

Measurements: Delirium was assessed for 5 days using the Confusion Assessment Method. The Barthel Index, Nottingham Extended ADL Scale, and SF-12 were used to determine ADL and IADL ability and self-reported health at baseline and 1- and 6-month follow-up. Cognition was assessed using the Mini-Mental State Examination at baseline and 6-month follow-up.

Results: Participants had lower IADL scores 1 month after SAVR than at baseline (baseline 58, 1 month: delirium 42, no delirium 50, P ≤.02), but scores had returned to baseline levels at 6 months. The Medical Outcomes Study 12-item Short-Form Health Survey (SF-12) Physical Component Summary (PCS) score was higher at 6-month follow-up (48) than at baseline (39), especially in participants who did not develop delirium (P <.001). No differences in other outcomes were found. Regression models suggest that delirium may help predict IADL disability 1 month after baseline (P ≤.07) but does not predict large differences in ADL disability, cognitive function, or SF-12-scores. Individuals who underwent TAVI and developed delirium had lower ADL (baseline 19, 1-month 16, P <.001) and IADL (baseline 49, 1-month 40, P =.003) scores at 1-month follow-up. SF-12 PCS score (baseline 30) increased from baseline to 1- (35, P =.04) and 6- (35, P =.02) month follow-up in individuals who underwent TAVI and did not develop delirium. Delirium after TAVI predicted greater ADL and IADL disability at 1-month but not at 6-month follow-up.

Conclusion: Individuals who develop delirium after SAVR and TAVI have poorer short-term IADL function but do not seem to have long-term reductions in physical, mental, or self-reported health.

Place, publisher, year, edition, pages
2016. Vol. 64, no 6, 1178-1186 p.
Keyword [en]
aortic stenosis, delirium, self-reported health status, TAVI
National Category
Gerontology, specializing in Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hj:diva-31263DOI: 10.1111/jgs.14165PubMedID: 27106745ScopusID: 2-s2.0-84975317716Local ID: HHJADULTISOAI: oai:DiVA.org:hj-31263DiVA: diva2:953104
Note

On behalf of the Delirium in Octogenarians Undergoing Cardiac Surgery or Intervention–CARDELIR Investigators

Available from: 2016-08-16 Created: 2016-08-16 Last updated: 2016-09-13Bibliographically approved

Open Access in DiVA

Publisher's PDF(235 kB)3 downloads
File information
File name FULLTEXT01.pdfFile size 235 kBChecksum SHA-512
62f7de8e8cc2732fe13fd0362db0dd199543dc977490494847b69b9b13f70979ad52c08567dd351c7b4e46ac0f04398913398c1a88158b28217a8ea5e3deb110
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMedScopus

Search in DiVA

By author/editor
Fridlund, Bengt
By organisation
HHJ, Dep. of Nursing ScienceHHJ. ADULT
In the same journal
Journal of The American Geriatrics Society
Gerontology, specializing in Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
Total: 3 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 15 hits
ReferencesLink to record
Permanent link

Direct link