Donepezil treatment is associated with improved outcomes in critically ill dementia patients via a reduction in delirium.
Alzheimers Dement
; 19(5): 1742-1751, 2023 05.
Article
en En
| MEDLINE
| ID: mdl-36218161
ABSTRACT
INTRODUCTION:
During hospital admissions, patients with dementia are at risk for developing delirium, an acute state of brain failure associated with significant morbidity. There are currently no pharmacologic tools to treat or prevent delirium. Decreased cholinergic signaling plays a role in the pathophysiology of both disorders. Whether enhanced pre-hospital cholinergic signaling in patients with dementia improves outcomes during critical illness remains unknown.METHODS:
We utilized the Medical Information Mart for Intensive Care III (MIMIC-III) database to determine whether pre-hospital donepezil use was associated with improved outcomes during critical illness in dementia patients.RESULTS:
We identified 2734 subjects with dementia admitted to the intensive care unit (ICU; 447 received donepezil). After adjusting for confounders, patients with dementia who were receiving donepezil had a significantly reduced in-hospital and 90-day mortality, ICU length of stay, and duration of mechanical ventilation. Donepezil use was associated with, and its benefit was mediated by, reduced delirium.DISCUSSION:
Patients with dementia who are treated with donepezil have improved outcomes during critical illness and reductions in delirium. HIGHLIGHTS No pharmacologic treatments exist to reduce delirium in patients with dementia. Donepezil improves outcomes during critical illness in patients with dementia. Improved outcomes are mediated by a reduction in hospital delirium. Future studies in patients with dementia should prospectively evaluate donepezil in the prevention of delirium.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
/
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
1_doencas_nao_transmissiveis
/
6_alzheimer_other_dementias
/
6_mental_health_behavioral_disorders
Asunto principal:
Delirio
/
Demencia
Tipo de estudio:
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Alzheimers Dement
Año:
2023
Tipo del documento:
Article
País de afiliación:
Estados Unidos