Symptoms of delirium during a stroke could point to worse outcomes

Symptoms of delirium during a stoke could point to worse outcomes
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Stroke patients who experience symptoms of delirium during a stroke could be more vulnerable to long-term cognitive and psychiatric difficulties.

Around 9,000 people are admitted to hospitals with a stroke in Norway each year. Many stroke patients experience a temporary state of acute confusion. This condition is known as delirium and often occurs in connection with illness and medical interventions.

Researchers have recently discovered that patients who experience symptoms of delirium during a stroke sometimes experience worse cognitive and emotional challenges down the line.

Identifying delirium

Approximately 10% of stroke patients experience symptoms of delirium in Norway. Delirium can be characterised by a patient suddenly appearing disoriented and inattentive.

People with symptoms of delirium may be easily distracted, struggle to maintain a conversational thread, and speech may be incoherent. The condition eases with time, however, the length of the condition can vary greatly in each patient. Even if the state of confusion is temporary, assessing whether it can cause long-term problems for stroke patients is important.

Researchers from the Norwegian University of Science and Technology (NTNU) wanted to investigate if delirium during a stroke can have a long-term impact on patients. The research team completed a study, which was led by Ramune Grambaite, associate professor in clinical neuropsychology at NTNU.

Symptoms of delirium associated with cognitive decline

The researcher’s analysis showed patients with symptoms of delirium scored worse on cognitive tests three, 18, and 36 months after their stroke. Suggesting that patients with delirium did experience greater cognitive impairment than those without delirium.

Delirium was also found to increase the likelihood of anxiety and other emotional symptoms in the years following the stroke. The researchers used questionnaires to map these emotional difficulties.

The researchers said they could not identify one specific reason why delirium might increase the chance of cognitive and psychiatric symptoms. They have speculated it may be because patients who experience delirium have greater vulnerabilities at the outset.

However, even when factors such as dementia, complications and other illnesses during the stroke were controlled, the study still yielded similar results.  The researchers have also suggested that the experience of delirium itself may affect the rehabilitation process, as it can be an unsettling mental experience for the patient.

The specific mechanisms that produce the described symptoms have not yet been successfully identified, and the researcher has urged that the condition is taken more seriously. They have stated that a state of confusion should be treated as a warning sign the patient is experiencing major medical and psychological stress during the stroke. The findings of this study show that this may have serious consequences in the future.

The findings suggest that stroke patients with symptoms of delirium could need special follow-up in the stroke’s post-acute phase. The researchers have emphasised that more research is needed in this area to improve knowledge and provide better follow-up treatment.

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