{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T13:09:52Z","timestamp":1793970592146,"version":"4.8.0"},"reference-count":31,"publisher":"BMJ","license":[{"start":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T00:00:00Z","timestamp":1711497600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ"],"accepted":{"date-parts":[[2024,2,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the strength and nature of the association between delirium and incident dementia in a population of older adult patients without dementia at baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study using large scale hospital administrative data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Public and private hospitals in New South Wales, Australia between July 2001 and March 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Data were extracted for 650\u2009590 hospital patients aged \u226565 years. Diagnoses of dementia and delirium were identified from ICD-10 (international classification of diseases, 10th revision) codes. Patients with dementia at baseline were excluded. Delirium-no delirium pairs were identified by matching personal and clinical characteristics, and were followed for more than five years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Cox proportional hazards models and Fine-Gray hazard models were used to estimate the associations of delirium with death and incident dementia, respectively. Delirium-outcome dose-response associations were quantified, all analyses were performed in men and women separately, and sensitivity analyses were conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 55\u2009211 matched pairs (48% men, mean age 83.4 years, standard deviation 6.5 years). Collectively, 58% (n=63\u2009929) of patients died and 17% (n=19\u2009117) had a newly reported dementia diagnosis during 5.25 years of follow-up. Patients with delirium had 39% higher risk of death (hazard ratio 1.39, 95% confidence interval 1.37 to 1.41) and three times higher risk of incident dementia (subdistribution hazard ratio 3.00, 95% confidence interval 2.91 to 3.10) than patients without delirium. The association with dementia was stronger in men (P=0.004). Each additional episode of delirium was associated with a 20% increased risk of dementia (subdistribution hazard ratio 1.20, 95% confidence interval 1.18 to 1.23).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The study findings suggest delirium was a strong risk factor for death and incident dementia among older adult patients. The data support a causal interpretation of the association between delirium and dementia. The clinical implications of delirium as a potentially modifiable risk factor for dementia are substantial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmj-2023-077634","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T20:07:45Z","timestamp":1711570065000},"page":"e077634","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":71,"title":["Delirium and incident dementia in hospital patients in New South Wales, Australia: retrospective cohort study"],"prefix":"10.1136","volume":"384","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9985-6404","authenticated-orcid":false,"given":"Emily H","family":"Gordon","sequence":"first","affiliation":[{"name":"Centre for Health Services Research, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, QLD, Australia"},{"name":"Australian Frailty Network, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, QLD, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5476-9526","authenticated-orcid":false,"given":"David D","family":"Ward","sequence":"additional","affiliation":[{"name":"Centre for Health Services Research, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, QLD, Australia"},{"name":"Australian Frailty Network, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, QLD, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6842-1667","authenticated-orcid":false,"given":"Hao","family":"Xiong","sequence":"additional","affiliation":[{"name":"Centre for Health Informatics, Macquarie University, North Ryde, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2638-4121","authenticated-orcid":false,"given":"Shlomo","family":"Berkovsky","sequence":"additional","affiliation":[{"name":"Centre for Health Informatics, Macquarie University, North Ryde, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8688-5836","authenticated-orcid":false,"given":"Ruth E","family":"Hubbard","sequence":"additional","affiliation":[{"name":"Centre for Health Services Research, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, QLD, Australia"},{"name":"Australian Frailty Network, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, QLD, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,3,27]]},"reference":[{"key":"2025110102354949000_384.mar27_6.e077634.1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afaa040"},{"key":"2025110102354949000_384.mar27_6.e077634.2","doi-asserted-by":"publisher","DOI":"10.1017\/S1478951520001297"},{"key":"2025110102354949000_384.mar27_6.e077634.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.1013"},{"key":"2025110102354949000_384.mar27_6.e077634.4","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.2273"},{"key":"2025110102354949000_384.mar27_6.e077634.5","doi-asserted-by":"publisher","DOI":"10.1002\/gps.5508"},{"key":"2025110102354949000_384.mar27_6.e077634.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2010.02767.x"},{"key":"2025110102354949000_384.mar27_6.e077634.7","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-022-00698-7"},{"key":"2025110102354949000_384.mar27_6.e077634.8","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afaa244"},{"key":"2025110102354949000_384.mar27_6.e077634.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30367-6"},{"key":"2025110102354949000_384.mar27_6.e077634.10","unstructured":"Centre for Health Record Linkage. 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