{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:43:48Z","timestamp":1786977828393,"version":"build-2736575974"},"reference-count":39,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,4,27]],"date-time":"2016-04-27T00:00:00Z","timestamp":1461715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["F32NR014777"],"award-info":[{"award-number":["F32NR014777"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["R01NR012242"],"award-info":[{"award-number":["R01NR012242"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Geriat Psychiatry"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To determine (1) whether delirium severity was associated with\n                      <jats:italic>Apolipoprotein E<\/jats:italic>\n                      (\n                      <jats:italic>APOE<\/jats:italic>\n                      ) genotype status and occupational complexity, a measure of cognitive reserve, in individuals with delirium superimposed on dementia; and (2) whether decline in delirium severity was associated with these same factors over a post\u2010acute care (PAC) stay.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Control group data (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009142) from a completed randomized clinical trial were used to address the aims of the study. Delirium severity was calculated by combining items from the Confusion Assessment Method and the Montreal Cognitive Assessment.\n                      <jats:italic>APOE \u03b54<\/jats:italic>\n                      carriers versus non\u2010carriers were considered. Occupational complexity, a measure of cognitive reserve, was derived from the Lifetime of Experiences Questionnaire. Covariates examined included age, gender, education, Clinical Dementia Rating Scale, and the Charlson comorbidity score. Data were nested (i.e., days nested within persons) and analyzed using multilevel models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The presence of an\n                      <jats:italic>APOE \u03b54<\/jats:italic>\n                      allele and higher Clinical Dementia Rating Scale were associated with greater delirium severity at baseline. The presence of an\n                      <jats:italic>APOE<\/jats:italic>\n                      \u03b54 allele was also associated with greater delirium severity averaged across the PAC stay. Occupational complexity was not associated with baseline delirium severity or average daily delirium severity; however, individuals with low occupational complexity showed a significant decreased in delirium severity during the course of their PAC stay.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Individual differences, including genetic factors and level of cognitive reserve, contribute to the severity of delirium in older adults with dementia. Copyright \u00a9 2016 John Wiley &amp; Sons, Ltd.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/gps.4496","type":"journal-article","created":{"date-parts":[[2016,4,27]],"date-time":"2016-04-27T23:06:43Z","timestamp":1461798403000},"page":"574-581","source":"Crossref","is-referenced-by-count":14,"title":["Genetic and environmental factors associated with delirium severity in older adults with dementia"],"prefix":"10.1002","volume":"32","author":[{"given":"Lauren","family":"Massimo","sequence":"first","affiliation":[{"name":"College of Nursing The Pennsylvania State University  University Park PA USA"},{"name":"Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine University of Pennsylvania  Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Munoz","sequence":"additional","affiliation":[{"name":"School of Psychology University of California  Riverside CA 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