Associations Between Depression Symptom Burden and Delirium Risk: A Prospective Cohort Study
Abstract Background and Objectives Delirium and depression are prevalent in aging. There is considerable clinical overlap, including shared symptoms and comorbid conditions, including Alzheimer’s disease, functional decline, and mortality. Despite this, the long-term relationship between depression...
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| description | Abstract
Background and Objectives
Delirium and depression are prevalent in aging. There is considerable clinical overlap, including shared symptoms and comorbid conditions, including Alzheimer’s disease, functional decline, and mortality. Despite this, the long-term relationship between depression and delirium remains unclear. This study assessed the associations of depression symptom burden and its trajectory with delirium risk in a 12-year prospective study of older hospitalized individuals.
Research Design and Methods
A total of 319 141 UK Biobank participants between 2006 and 2010 (mean age 58 years [range 37–74, SD = 8], 54% women) reported frequency (0–3) of 4 depressive symptoms (mood, disinterest, tenseness, or lethargy) in the preceding 2 weeks prior to initial assessment visit and aggregated into a depressive symptom burden score (0–12). New-onset delirium was obtained from hospitalization records during 12 years of median follow-up. 40 451 (mean age 57 ± 8; range 40–74 years) had repeat assessment on average 8 years after their first visit. Cox proportional hazard models examined whether depression symptom burden and trajectory predicted incident delirium.
Results
A total of 5 753 (15 per 1 000) newly developed delirium during follow-up. Increased risk for delirium was seen for mild (aggregated scores 1–2, hazards ratio, HR = 1.16, [95% confidence interval (CI): 1.08–1.25], p |
| doi_str_mv | 10.1093/geroni/igae029 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11041407</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A797787714</galeid><oup_id>10.1093/geroni/igae029</oup_id><sourcerecordid>A797787714</sourcerecordid><originalsourceid>FETCH-LOGICAL-c447t-1d3317b02ff7350e362dae68f6cbe6a20861e9120a953966f509687b4f12d3513</originalsourceid><addsrcrecordid>eNqFkc9rFDEUx4MottRePUrAix62TSaZZOJFtutPKChWb0LIZl620ZlkTDKV_e_NsmupUJAcXnjfz_uSvC9CTyk5o0Sx8w2kGPy53xggjXqAjhum1KJlhDy8cz9Cpzn_IIRQxbjizWN0xDohCKX8GH1f5hytN8XHkPEFlN8AAb-BKUHOtYevtuNU4ogv5tRXxYS-qoNPfh7xF59_vsJL_DnFPIEt_gbwKl7HVPBVmfvtE_TImSHD6aGeoG_v3n5dfVhcfnr_cbW8XFjOZVnQnjEq16RxTrKWABNNb0B0Ttg1CNOQTlBQtCFGtUwJ4VqiRCfX3NGmZy1lJ-j13nea1yP0FkJJZtBT8qNJWx2N1_8qwV_rTbzRlBJOOZHV4cXBIcVfM-SiR58tDIMJEOesGeGipYpKXtHne3RjBtA-uFgt7Q7XS6mk7KSkO-rsHqqeHkZvYwDna_--AVuXmRO42-dTondp633a-pB2HXh299O3-N9sK_ByD8R5-p_ZH9BftTc</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3046519174</pqid></control><display><type>article</type><title>Associations Between Depression Symptom Burden and Delirium Risk: A Prospective Cohort Study</title><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Oxford Journals Open Access Collection</source><source>PubMed Central</source><creator>Gaba, Arlen ; Li, Peng ; Zheng, Xi ; Gao, Chenlu ; Cai, Ruixue ; Hu, Kun ; Gao, Lei</creator><contributor>D. Niznik, Joshua</contributor><creatorcontrib>Gaba, Arlen ; Li, Peng ; Zheng, Xi ; Gao, Chenlu ; Cai, Ruixue ; Hu, Kun ; Gao, Lei ; D. Niznik, Joshua</creatorcontrib><description>Abstract
Background and Objectives
Delirium and depression are prevalent in aging. There is considerable clinical overlap, including shared symptoms and comorbid conditions, including Alzheimer’s disease, functional decline, and mortality. Despite this, the long-term relationship between depression and delirium remains unclear. This study assessed the associations of depression symptom burden and its trajectory with delirium risk in a 12-year prospective study of older hospitalized individuals.
Research Design and Methods
A total of 319 141 UK Biobank participants between 2006 and 2010 (mean age 58 years [range 37–74, SD = 8], 54% women) reported frequency (0–3) of 4 depressive symptoms (mood, disinterest, tenseness, or lethargy) in the preceding 2 weeks prior to initial assessment visit and aggregated into a depressive symptom burden score (0–12). New-onset delirium was obtained from hospitalization records during 12 years of median follow-up. 40 451 (mean age 57 ± 8; range 40–74 years) had repeat assessment on average 8 years after their first visit. Cox proportional hazard models examined whether depression symptom burden and trajectory predicted incident delirium.
Results
A total of 5 753 (15 per 1 000) newly developed delirium during follow-up. Increased risk for delirium was seen for mild (aggregated scores 1–2, hazards ratio, HR = 1.16, [95% confidence interval (CI): 1.08–1.25], p < .001), modest (scores 3–5, 1.30 [CI: 1.19–1.43], p < .001), and severe (scores ≥ 5, 1.38 [CI: 1.24–1.55], p < .001) depressive symptoms, versus none in the fully adjusted model. These findings were independent of the number of hospitalizations and consistent across settings (eg, surgical, medical, or critical care) and specialty (eg, neuropsychiatric, cardiorespiratory, or other). Worsening depression symptoms (≥1 point increase), compared to no change/improved score, were associated with an additional 39% increased risk (1.39 [1.03–1.88], p = .03) independent of baseline depression burden. The association was strongest in those over 65 years at baseline (p for interaction <.001).
Discussion and Implications
Depression symptom burden and worsening trajectory predicted delirium risk during hospitalization. Increased awareness of subclinical depression symptoms may aid delirium prevention.</description><identifier>ISSN: 2399-5300</identifier><identifier>EISSN: 2399-5300</identifier><identifier>DOI: 10.1093/geroni/igae029</identifier><identifier>PMID: 38660114</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Care and treatment ; Delirium ; Depression, Mental ; Diagnosis ; Original</subject><ispartof>Innovation in aging, 2024-05, Vol.8 (5), p.igae029</ispartof><rights>The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America. 2024</rights><rights>The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America.</rights><rights>COPYRIGHT 2024 Oxford University Press</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c447t-1d3317b02ff7350e362dae68f6cbe6a20861e9120a953966f509687b4f12d3513</cites><orcidid>0000-0003-1476-1460 ; 0000-0002-4684-4909</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11041407/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11041407/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,1604,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38660114$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>D. Niznik, Joshua</contributor><creatorcontrib>Gaba, Arlen</creatorcontrib><creatorcontrib>Li, Peng</creatorcontrib><creatorcontrib>Zheng, Xi</creatorcontrib><creatorcontrib>Gao, Chenlu</creatorcontrib><creatorcontrib>Cai, Ruixue</creatorcontrib><creatorcontrib>Hu, Kun</creatorcontrib><creatorcontrib>Gao, Lei</creatorcontrib><title>Associations Between Depression Symptom Burden and Delirium Risk: A Prospective Cohort Study</title><title>Innovation in aging</title><addtitle>Innov Aging</addtitle><description>Abstract
Background and Objectives
Delirium and depression are prevalent in aging. There is considerable clinical overlap, including shared symptoms and comorbid conditions, including Alzheimer’s disease, functional decline, and mortality. Despite this, the long-term relationship between depression and delirium remains unclear. This study assessed the associations of depression symptom burden and its trajectory with delirium risk in a 12-year prospective study of older hospitalized individuals.
Research Design and Methods
A total of 319 141 UK Biobank participants between 2006 and 2010 (mean age 58 years [range 37–74, SD = 8], 54% women) reported frequency (0–3) of 4 depressive symptoms (mood, disinterest, tenseness, or lethargy) in the preceding 2 weeks prior to initial assessment visit and aggregated into a depressive symptom burden score (0–12). New-onset delirium was obtained from hospitalization records during 12 years of median follow-up. 40 451 (mean age 57 ± 8; range 40–74 years) had repeat assessment on average 8 years after their first visit. Cox proportional hazard models examined whether depression symptom burden and trajectory predicted incident delirium.
Results
A total of 5 753 (15 per 1 000) newly developed delirium during follow-up. Increased risk for delirium was seen for mild (aggregated scores 1–2, hazards ratio, HR = 1.16, [95% confidence interval (CI): 1.08–1.25], p < .001), modest (scores 3–5, 1.30 [CI: 1.19–1.43], p < .001), and severe (scores ≥ 5, 1.38 [CI: 1.24–1.55], p < .001) depressive symptoms, versus none in the fully adjusted model. These findings were independent of the number of hospitalizations and consistent across settings (eg, surgical, medical, or critical care) and specialty (eg, neuropsychiatric, cardiorespiratory, or other). Worsening depression symptoms (≥1 point increase), compared to no change/improved score, were associated with an additional 39% increased risk (1.39 [1.03–1.88], p = .03) independent of baseline depression burden. The association was strongest in those over 65 years at baseline (p for interaction <.001).
Discussion and Implications
Depression symptom burden and worsening trajectory predicted delirium risk during hospitalization. Increased awareness of subclinical depression symptoms may aid delirium prevention.</description><subject>Care and treatment</subject><subject>Delirium</subject><subject>Depression, Mental</subject><subject>Diagnosis</subject><subject>Original</subject><issn>2399-5300</issn><issn>2399-5300</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><recordid>eNqFkc9rFDEUx4MottRePUrAix62TSaZZOJFtutPKChWb0LIZl620ZlkTDKV_e_NsmupUJAcXnjfz_uSvC9CTyk5o0Sx8w2kGPy53xggjXqAjhum1KJlhDy8cz9Cpzn_IIRQxbjizWN0xDohCKX8GH1f5hytN8XHkPEFlN8AAb-BKUHOtYevtuNU4ogv5tRXxYS-qoNPfh7xF59_vsJL_DnFPIEt_gbwKl7HVPBVmfvtE_TImSHD6aGeoG_v3n5dfVhcfnr_cbW8XFjOZVnQnjEq16RxTrKWABNNb0B0Ttg1CNOQTlBQtCFGtUwJ4VqiRCfX3NGmZy1lJ-j13nea1yP0FkJJZtBT8qNJWx2N1_8qwV_rTbzRlBJOOZHV4cXBIcVfM-SiR58tDIMJEOesGeGipYpKXtHne3RjBtA-uFgt7Q7XS6mk7KSkO-rsHqqeHkZvYwDna_--AVuXmRO42-dTondp633a-pB2HXh299O3-N9sK_ByD8R5-p_ZH9BftTc</recordid><startdate>20240501</startdate><enddate>20240501</enddate><creator>Gaba, Arlen</creator><creator>Li, Peng</creator><creator>Zheng, Xi</creator><creator>Gao, Chenlu</creator><creator>Cai, Ruixue</creator><creator>Hu, Kun</creator><creator>Gao, Lei</creator><general>Oxford University Press</general><scope>TOX</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-1476-1460</orcidid><orcidid>https://orcid.org/0000-0002-4684-4909</orcidid></search><sort><creationdate>20240501</creationdate><title>Associations Between Depression Symptom Burden and Delirium Risk: A Prospective Cohort Study</title><author>Gaba, Arlen ; Li, Peng ; Zheng, Xi ; Gao, Chenlu ; Cai, Ruixue ; Hu, Kun ; Gao, Lei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c447t-1d3317b02ff7350e362dae68f6cbe6a20861e9120a953966f509687b4f12d3513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Care and treatment</topic><topic>Delirium</topic><topic>Depression, Mental</topic><topic>Diagnosis</topic><topic>Original</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gaba, Arlen</creatorcontrib><creatorcontrib>Li, Peng</creatorcontrib><creatorcontrib>Zheng, Xi</creatorcontrib><creatorcontrib>Gao, Chenlu</creatorcontrib><creatorcontrib>Cai, Ruixue</creatorcontrib><creatorcontrib>Hu, Kun</creatorcontrib><creatorcontrib>Gao, Lei</creatorcontrib><collection>Oxford Journals Open Access Collection</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Innovation in aging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gaba, Arlen</au><au>Li, Peng</au><au>Zheng, Xi</au><au>Gao, Chenlu</au><au>Cai, Ruixue</au><au>Hu, Kun</au><au>Gao, Lei</au><au>D. Niznik, Joshua</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Associations Between Depression Symptom Burden and Delirium Risk: A Prospective Cohort Study</atitle><jtitle>Innovation in aging</jtitle><addtitle>Innov Aging</addtitle><date>2024-05-01</date><risdate>2024</risdate><volume>8</volume><issue>5</issue><spage>igae029</spage><pages>igae029-</pages><issn>2399-5300</issn><eissn>2399-5300</eissn><abstract>Abstract
Background and Objectives
Delirium and depression are prevalent in aging. There is considerable clinical overlap, including shared symptoms and comorbid conditions, including Alzheimer’s disease, functional decline, and mortality. Despite this, the long-term relationship between depression and delirium remains unclear. This study assessed the associations of depression symptom burden and its trajectory with delirium risk in a 12-year prospective study of older hospitalized individuals.
Research Design and Methods
A total of 319 141 UK Biobank participants between 2006 and 2010 (mean age 58 years [range 37–74, SD = 8], 54% women) reported frequency (0–3) of 4 depressive symptoms (mood, disinterest, tenseness, or lethargy) in the preceding 2 weeks prior to initial assessment visit and aggregated into a depressive symptom burden score (0–12). New-onset delirium was obtained from hospitalization records during 12 years of median follow-up. 40 451 (mean age 57 ± 8; range 40–74 years) had repeat assessment on average 8 years after their first visit. Cox proportional hazard models examined whether depression symptom burden and trajectory predicted incident delirium.
Results
A total of 5 753 (15 per 1 000) newly developed delirium during follow-up. Increased risk for delirium was seen for mild (aggregated scores 1–2, hazards ratio, HR = 1.16, [95% confidence interval (CI): 1.08–1.25], p < .001), modest (scores 3–5, 1.30 [CI: 1.19–1.43], p < .001), and severe (scores ≥ 5, 1.38 [CI: 1.24–1.55], p < .001) depressive symptoms, versus none in the fully adjusted model. These findings were independent of the number of hospitalizations and consistent across settings (eg, surgical, medical, or critical care) and specialty (eg, neuropsychiatric, cardiorespiratory, or other). Worsening depression symptoms (≥1 point increase), compared to no change/improved score, were associated with an additional 39% increased risk (1.39 [1.03–1.88], p = .03) independent of baseline depression burden. The association was strongest in those over 65 years at baseline (p for interaction <.001).
Discussion and Implications
Depression symptom burden and worsening trajectory predicted delirium risk during hospitalization. Increased awareness of subclinical depression symptoms may aid delirium prevention.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>38660114</pmid><doi>10.1093/geroni/igae029</doi><orcidid>https://orcid.org/0000-0003-1476-1460</orcidid><orcidid>https://orcid.org/0000-0002-4684-4909</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Innovation in aging, 2024-05, Vol.8 (5), p.igae029 |
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| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford Journals Open Access Collection; PubMed Central |
| subjects | Care and treatment Delirium Depression, Mental Diagnosis Original |
| title | Associations Between Depression Symptom Burden and Delirium Risk: A Prospective Cohort Study |
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