Critical illness and long-term cognitive impairment

This study reports the association between long-term cognitive impairment and survivors of critical illness in adult intensive care patients. As part of the BRAIN-ICU study, 821 patients with respiratory failure or shock were enrolled from the medical and surgical intensive care units. Their global cognition and executive function were assessed at 3 and 12 months following discharge using the Repeatable Battery for the Assessment of Neuropsychological status and the Trail Making Test, Part B. A significant number of both older and younger patients were found to have cognitive deficits below the population mean at 3 months (40%), and in 24% of them it persisted at 12 months. This association was stronger in patients with longer duration of delirium, which was independently associated with worse outcomes, for both global cognition and executive functioning. This study provides further evidence that patients with delirium are at a higher risk of developing long-term cognitive impairment and dementia, and their worse cognitive functioning is related to the length of their delirium episode.