Maturitas · Oct 15, 2026

Mortality amongst older patients with delirium superimposed on dementia and malnutrition: A six-year follow-up study

By Enwere P, Yeong K, Lisk R et al.

OBJECTIVE: This study assessed the association of delirium, superimposed on dementia and malnutrition, with the risk of death after hospital discharge in older adults. METHODS: This retrospective follow-up study comprised 554 patients aged 61.3-105.3 years (mean 85.5 years, SD 7.6) admitted between 01/04/2019 and 31/01/2020 with acute delirium at a single hospital (United Kingdom). It evaluated the associations between mortality after hospital discharge and the following patient groups: 1) well-nourished without dementia; 2) malnutrition without dementia; 3) well-nourished with delirium superimposed on dementia; and 4) malnutrition with delirium superimposed on dementia. Multivariable logistic and Cox regressions were done, adjusted for age, sex, polypharmacy, anticholinergic burden and comorbidities. RESULTS: Survivors to discharge (n = 497) were followed for a mean of 6.2 years (74.4 months). The median time from discharge to death was 15.2 months (interquartile range 4.9-33.4). Compared with well-nourished patients without dementia, those with malnutrition and delirium superimposed on dementia had the greatest risks of post-discharge mortality both within one month (odds ratio 6.10, 95% confidence interval 2.4-15.3) and over a 6.2-year period (hazard ratio 1.48, 95% confidence interval 1.13-1.93). The post-discharge median survival time was 26 months for well-nourished patients without dementia, compared with 18 months for patients with malnutrition and without dementia; 16 months for well-nourished patients with delirium superimposed on dementia; and 13 months for those with both malnutrition and delirium superimposed on dementia. CONCLUSIONS: Older adults with delirium superimposed on dementia and malnutrition have an increased risk of short- and long-term mortality after hospitalisation for delirium. This combination can serve as an indicator for the identification of high-risk patients.

doi.org/10.1016/j.maturitas.2026.109154Open accessPubMed 42896356Populations