Readmissions did not explain delirium’s link to cognitive decline
After elective surgery, delirium was linked to a 0.33-unit faster yearly decline on a combined thinking-test score than in people without delirium.
Our read
Populations- Studied:
- Cohort study of 560 older adults undergoing major elective surgery, against patients without delirium (Dose-response)
- What changed:
- Accounting for readmissions barely changed delirium’s link to faster cognitive decline (-6% to -9%)
- The catch:
- Missing prior stroke and medication histories could confound the link between delirium and cognitive decline
- In the record:
- One of 3 papers on rehospitalization on record: 3 with results in people.
Editor of record: Boris Djordjevic · AgingResearch.News
Among 560 community-dwelling adults aged 70 or older without clinical dementia, a prospective observational cohort study tracked cognitive performance for five years after major elective surgery. Participants averaged 76.7 years old; 326 were women. Researchers assessed delirium, a sudden state of confusion and impaired attention, during the initial hospital stay. They combined results from 11 cognitive tests before surgery and at 10 follow-up assessments.
Delirium was associated with a 0.33-unit faster annual decline in the combined score than no delirium. Each rehospitalization was associated with a 0.19-unit yearly decline. Accounting for repeat hospital stays barely changed the delirium–decline association. Readmissions did not explain that link in this analysis.
Why it matters
Cognitive decline in older adults may reflect delirium itself or the illness and frailty that make delirium more likely. Distinguishing these possibilities matters for understanding long-term decline after surgery.
Caveats
Hospital readmissions measured illness and frailty only indirectly; health differences not captured by admissions could still help explain the link. The findings concern adults aged 70 or older without clinical dementia who underwent elective surgery.
From the paper
- Result
The slope of LTCD in the non-delirium group was −0.96 (95% CI −1.09, −0.82), and when combined with the additional effect of delirium (−0.33 unit faster per year), the overall slope in the delirium group was −1.29 GCP units (−0.96 + −0.33) per year, or −0.13 standard deviations units per year.
- Limitation
The attrition rate was 21% at 60 months (with deaths accounting for 14%); however, multiple sensitivity analyses accounting for these losses did not alter the conclusions.
Quoted word for word from the full text on PubMed Central.
The paper
Brigham and Women's Hospital; Beth Israel Deaconess Medical Center
JAMA Internal Medicine, Jun 8, 2026, Open access, accepted manuscript
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