Delirium is a severe neuropsychiatric condition characterized by acute-onset deficits in attention and other cognitive functions. This slide deck presents current knowledge about delirium in relation to stroke, covering topics such as risk factors for post-stroke delirium, diagnosis, and treatment.

This slide deck has been developed by Professor Terence J Quinn, University of Glasgow, Scotland, and Professor Christopher Chen, National University of Singapore, and Director of the Memory Aging and Cognition Centre, Singapore, in collaboration with Cambridge (a division of Prime, Cambridge, UK).

Index for
slide deck

Introduction

Delirium
Delirium
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Case presentation
Case presentation

The slide details a case study of a patient who developed delirium after experiencing stroke.

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Delirium
Delirium

Delirium is a medical condition characterized by acute-onset deficits in attention and other aspects of cognition.1 Various terms have been used in the past for this constellation of symptoms, e.g., ‘acute confusional state’, and ‘organic brain syndrome’.1 This inconsiste…

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The history of delirium
The history of delirium

As shown on the slide, the term delirium has been used inconsistently in its history stretching back several centuries.1

Reference:
1. Adamis D, Treloar A, Martin FC, Macdonald AJ. A brief review of the history of delirium as a mental disorder. Hist Psychiatry 2007; 18: 459–469.

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Definitions
Definitions

Delirium is a neurocognitive disorder characterized by an acute disturbance in attention, which can be hypo- or hyper-active, or mixed.1

References:
1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders – fifth edition text revision. A…

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Epidemiology and risk factors

Epidemiology and risk factors
Epidemiology and risk factors
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Delirium and stroke
Delirium and stroke

Delirium is common in stroke, and is associated with poorer outcomes for the patient.2,3 However, the pathogenesis of delirium is poorly understood and thought to involve a multitude of interacting factors which increase the risk of a person experiencing delirium.1

Refere…

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Occurrence of delirium in acute stroke
Occurrence of delirium in acute stroke

This study followed 141 people after stroke and compared the usefulness of different methods for diagnosing delirium.1 The results, as shown on the slide, show delirium is a common occurrence after stroke, and usually presents within the first 72 hours after stroke.1 Alth…

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Pathology of delirium
Pathology of delirium

As outlined on the slide, there are many risk factors which can predispose a person to experiencing delirium.1 Because there is such a complex network of predisposing and precipitating factors, it is often difficult to assign a specific cause of delirium in a patient.1 Th…

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Risk factors for post-stroke delirium
Risk factors for post-stroke delirium

Given the negative effects of delirium on the outcomes of stroke, predicting the risk of a person after stroke of developing delirium is a valuable clinical ambition.1,5 One such tool has been developed that included age, stroke severity and subtype, and the presence of i…

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Prognosis

Prognosis
Prognosis
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Prognosis of delirium in stroke
Prognosis of delirium in stroke

Although common in people after stroke, the effect of delirium on clinical outcomes in the long term has been poorly studied.2 To address this deficit, the PROPOLIS study (prospective observational Polish study) followed a large group of people (n=682) after stroke, and s…

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Post-stroke delirium and cognitive impairment and dementia
Post-stroke delirium and cognitive impairment and dementia

People with delirium after stroke appear to be at a higher risk of developing dementia than people who do not experience delirium.1,2 However, delirium and dementia have a complex and interconnected relationship, making studies of the effect of post-stroke delirium on lat…

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The relationship between delirium and dementia
The relationship between delirium and dementia

Because delirium, cognitive impairment, and dementia appear to be inter-connected, strategies to prevent delirium may help reduce the risk of cognitive decline, or dementia, in older patients.1 As shown on the slide, the multitude of factors involved present many opportun…

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