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Is anemia associated with cognitive impairment and delirium among older acute surgical patients?
Author(s) -
Myint Phyo Kyaw,
Owen Stephanie,
McCarthy Kathryn,
Pearce Lyndsay,
Moug Susan J,
Stechman Michael J,
Hewitt Jonathan,
Carter Ben
Publication year - 2018
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/ggi.13293
Subject(s) - medicine , delirium , anemia , odds ratio , interquartile range , montreal cognitive assessment , hypoalbuminemia , polypharmacy , cognition , pediatrics , cognitive impairment , psychiatry
Aim The determinants of cognitive impairment and delirium during acute illness are poorly understood, despite being common among older people. Anemia is common in older people, and there is ongoing debate regarding the association between anemia, cognitive impairment and delirium, primarily in non‐surgical patients. Methods Using data from the Older Persons Surgical Outcomes Collaboration 2013 and 2014 audit cycles, we examined the association between anemia and cognitive outcomes in patients aged ≥65 years admitted to five UK acute surgical units. On admission, the Confusion Assessment Method was carried out to detect delirium. Cognition was assessed using the Montreal Cognitive Assessment, and two levels of impairment were defined as Montreal Cognitive Assessment <26 and <20. Logistic regression models were constructed to examine these associations in all participants, and individuals aged ≥75 years only. Results A total of 653 patients, with a median age of 76.5 years (interquartile range 73.0–80.0 years) and 53% women, were included. Statistically significant associations were found between anemia and age; polypharmacy; hyperglycemia; and hypoalbuminemia. There was no association between anemia and cognitive impairment or delirium. The adjusted odds ratios of cognitive impairment were 0.95 (95% CI 0.56–1.61) and 1.00 (95% CI 0.61–1.64) for the Montreal Cognitive Assessment <26 and <20, respectively. The adjusted odds ratio of delirium was 1.00 (95% CI 0.48–2.10) in patients with anemia compared with those without. Similar results were observed for the ≥75 years age group. Conclusions There was no association between anemia and cognitive outcomes among older people in this acute surgical setting. Considering the retrospective nature of the study and possible lack of power, findings should be taken with caution. Geriatr Gerontol Int 2018; 18: 1025–1030 .