Nurse is comforting a covid patient at the ICU

Currently, there are three hypotheses that identify how delirium might lead to dementia.

One of the many challenging effects that is common in COVID-19 survivors is temporary delirium. In fact, two separate studies found that 55 – 65% of those who became severely ill from the virus experienced the acute confusion that is the hallmark of delirium – compared to about 33% of those critically ill with other conditions. And while it may be short-lived, the long-term effects of COVID-19 related delirium are still being determined.

Delirium can occur whenever multiple stressors converge, such as a surgical procedure or infection in someone with a chronic medical condition. Tino Emanuele Pononi, neurologist at the Golgi Cenci Foundation in Italy, explains, “Delirium easily occurs when the brain is unable to compensate for a stressful situation.”

Over the past decade, it’s been noted that as little as one episode of delirium has been linked to an increased risk of later dementia, as well as an acceleration of the disease in those already experiencing cognitive decline. And, the longer a person is experiencing delirium, the greater the chance for cognitive impairment following the episode.

Because it takes years to follow patients who have experienced delirium, scientists are now only in the beginning stages of determining the particular effects of COVID-19-related delirium.

What has been established now are the following three hypotheses to identify how delirium might lead to dementia:

  1. The accumulation of toxic cellular material in the brain may cause damage in the short-term (in the form of delirium) and then later, longer-term damage (in the form of dementia).
  2. Inflammation may be triggered in the brain from a build-up of cellular material from severe infections and/or surgery. If this inflammation persists, it can lead to an acute case of delirium, deteriorating particular neurons and cells that can lead to cognitive damage.
  3. There may be a link between the fewer neuron connections in the brain that come with dementia and the loss of neurological reserves that are needed to help someone deal with infection or inflammation, causing delirium and then further advancing into dementia.

The encouraging news is there are steps hospitals can take to help reduce the rate of delirium. The HELP program is focused on reducing sedation, watching nutrition and hydration levels more closely, and bringing in family members to help with orientation and reassurance for patients. Statistics show that the incidence of delirium was lowered by nearly 40% by implementing these practices.

As researchers continue the long journey towards better understanding how delirium and dementia[AG3]  are connected, Atlanta Home Care Partners, providers of home care services in Decatur and nearby areas, is always here with the specialized care seniors with either condition need to stay safe and comfortable at home. Contact us at 404-228-0103 for assistance.