Editor's Correspondence |

Drugs May Exacerbate Cognitive Decline After Delirium in People With Dementia

J. Simon Bell, PhD
JAMA Intern Med. 2013;173(7):596-597. doi:10.1001/jamainternmed.2013.3280.
Text Size: A A A
Published online


Gross et al1 reported that those who developed in-hospital delirium experienced cognitive deterioration at twice the rate in the following year compared with those who did not develop delirium. The authors adjusted their analyses for a range of clinically important factors. However, the study did not consider the impact of prescribed drugs.

While the etiology of delirium is multifactorial, psychotropic drugs are common precipitants. If not identified in hospital and communicated to primary care physicians, use of these drugs may be continued or reinitiated following hospital discharge. Antipsychotics (eg, haloperidol) and benzodiazepines are also used to manage in-hospital delirium. Benzodiazepine and opioid analgesic therapies initiated in hospitals are often continued for long periods following discharge.2,3 Prescription and continued use of these drugs may have contributed to the greater cognitive deterioration observed in those who developed in-hospital delirium compared with those who had no delirium.4

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics

The Rational Clinical Examination
Make the Diagnosis: Delirium

The Rational Clinical Examination
Original Article: Does This Patient Have Delirium? Value of Bedside Instruments