Guerra et al evaluated elderly patients who were admitted to an intensive care unit (ICU). They identified risk factors during the admission that might be associated with a greater risk for future (presumably vascular) dementia. The authors are from Columbia University in New York City.


Patient selection: elderly Medicare beneficiaries receiving critical care >= 66 years old


Outcome: diagnosis of dementia in the 3 years following discharge



(1) pre-existing dementia or cognitive impairment

(2) cardiac surgery during admission or in preceding year


Risk factors for dementia after discharge from the ICU:

(1) infection or severe sepsis

(2) acute dialysis

(3) acute neurologic dysfunction (encephalopathy, anoxic brain damage, transient mental disorder)



• Presumable stroke would qualify for an acute neurologic dysfunction.

• While cardiac surgery was removed from the analysis, it will be added to the implementation.


Mechanical ventilation was not associated with an increased risk.


A patient with multiple risk factors should be monitored for cognitive function following discharge.


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