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. 2017 Mar 14;14(3):e1002247.
doi: 10.1371/journal.pmed.1002247. eCollection 2017 Mar.

Challenges and opportunities in understanding dementia and delirium in the acute hospital

Thomas A Jackson  1   2 , John R F Gladman  3 , Rowan H Harwood  4 , Alasdair M J MacLullich  5 , Elizabeth L Sampson  6 , Bart Sheehan  7 , Daniel H J Davis  8
Affiliations

Challenges and opportunities in understanding dementia and delirium in the acute hospital

Thomas A Jackson et al. PLoS Med. .

Abstract

In an Essay, Andrew Jackson and colleagues discuss challenges in the diagnosis and management of older people with dementia and delirium in acute hospitals.

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Conflict of interest statement

I have read the journal's policy and the authors of this manuscript have the following conflicts: JRFG is a researcher and clinician in the field covered by this paper, whose employing organisation holds research grant awards from The Alzheimer's Society and the NIHR (through CLAHRC and the PGfAR schemes) on which JRFG is an investigator. RHH holds research grants from the UK National Institute for Health Research (UK government) and is a member of The Alzheimer's Society, the topic review panel for the National Institute for Health Research, the National End of Life Care Intelligence Network steering committee, and the NHS Protect working group on clinically related violence.

Figures

Fig 1
Fig 1. Schematic representation of dementia disease trajectory over time influenced by hospital admission.
Dementia disease trajectories between a person with no hospital admissions (green line) and multiple hospital admissions (red line) are illustrated. The disease trajectory is negatively influenced by baseline frailty and disease expression. However, it may be positively tempered by early diagnosis, leading to better access to services, and advanced care planning. The “multiple hospital admissions” trajectory is further influenced by specific hospital interactions—importantly, delirium—but there are other effects from an acute inflammatory insult, subsequent recovery, and in-hospital iatrogenic insults.
See this image and copyright information in PMC

References

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