Advanced Age Is Associated With Catatonia in Critical Illness: Results From the Delirium and Catatonia Prospective Cohort Investigation
Introduction: Catatonia, characterized by motor, behavioral and affective abnormalities, frequently co-occurs with delirium during critical illness. Advanced age is a known risk factor for development of delirium. However, the association between age and catatonia has not been described. We aim to d...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-11-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2021.673166/full |
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| author | Jennifer Connell Jennifer Connell Ahra Kim Nathan E. Brummel Nathan E. Brummel Mayur B. Patel Mayur B. Patel Mayur B. Patel Simon N. Vandekar Pratik Pandharipande Pratik Pandharipande Robert S. Dittus Robert S. Dittus Stephan Heckers Stephan Heckers E. Wes Ely E. Wes Ely E. Wes Ely Jo Ellen Wilson Jo Ellen Wilson Jo Ellen Wilson |
| author_facet | Jennifer Connell Jennifer Connell Ahra Kim Nathan E. Brummel Nathan E. Brummel Mayur B. Patel Mayur B. Patel Mayur B. Patel Simon N. Vandekar Pratik Pandharipande Pratik Pandharipande Robert S. Dittus Robert S. Dittus Stephan Heckers Stephan Heckers E. Wes Ely E. Wes Ely E. Wes Ely Jo Ellen Wilson Jo Ellen Wilson Jo Ellen Wilson |
| author_sort | Jennifer Connell |
| collection | DOAJ |
| description | Introduction: Catatonia, characterized by motor, behavioral and affective abnormalities, frequently co-occurs with delirium during critical illness. Advanced age is a known risk factor for development of delirium. However, the association between age and catatonia has not been described. We aim to describe the occurrence of catatonia, delirium, and coma by age group in a critically ill, adult population.Design: Convenience cohort, nested within two clinical trials and two observational cohort studies.Setting: Intensive care units in an academic medical center in Nashville, TN.Patients: 378 critically ill adult patients on mechanical ventilation and/or vasopressors.Measurements and Main Results: Patients were assessed for catatonia, delirium, and coma by independent and blinded personnel, the Bush Francis Catatonia Rating Scale, the Confusion Assessment Method for the Intensive Care Unit (ICU) and the Richmond Agitation and Sedation Scale. Of 378 patients, 23% met diagnostic criteria for catatonia, 66% experienced delirium, and 52% experienced coma during the period of observation. There was no relationship found between age and catatonia severity or age and presence of specific catatonia items. The prevalence of catatonia was strongly associated with age in the setting of critical illness (p < 0.05). Delirium and comas' association with age was limited to the setting of catatonia.Conclusion: Given the significant relationship between age and catatonia independent of coma and delirium status, these data demonstrate catatonia's association with advanced age in the setting of critical illness. Future studies can explore the causative factors for this association and further elucidate the risk factors for acute brain dysfunction across the age spectrum. |
| first_indexed | 2024-12-19T03:14:58Z |
| format | Article |
| id | doaj.art-ca8c1f6ed7174d3fa315356f53652a82 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-12-19T03:14:58Z |
| publishDate | 2021-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-ca8c1f6ed7174d3fa315356f53652a822022-12-21T20:37:54ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402021-11-011210.3389/fpsyt.2021.673166673166Advanced Age Is Associated With Catatonia in Critical Illness: Results From the Delirium and Catatonia Prospective Cohort InvestigationJennifer Connell0Jennifer Connell1Ahra Kim2Nathan E. Brummel3Nathan E. Brummel4Mayur B. Patel5Mayur B. Patel6Mayur B. Patel7Simon N. Vandekar8Pratik Pandharipande9Pratik Pandharipande10Robert S. Dittus11Robert S. Dittus12Stephan Heckers13Stephan Heckers14E. Wes Ely15E. Wes Ely16E. Wes Ely17Jo Ellen Wilson18Jo Ellen Wilson19Jo Ellen Wilson20Critical Illness, Brain Dysfunction, and Survivorship Center, Center for Health Services Research, Nashville, TN, United StatesVanderbilt University School of Medicine, Nashville, TN, United StatesDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, United StatesCritical Illness, Brain Dysfunction, and Survivorship Center, Center for Health Services Research, Nashville, TN, United StatesDivision of Pulmonary, Critical Care, and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, United StatesCritical Illness, Brain Dysfunction, and Survivorship Center, Center for Health Services Research, Nashville, TN, United StatesDivision of Trauma and Surgical Critical Care, Departments of Surgery, Neurosurgery, and Hearing and Speech Sciences, Section of Surgical Sciences, Vanderbilt Brain Institute, Vanderbilt University Medical Center, Nashville, TN, United StatesGeriatric Research, Education, and Clinical Center Service, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, United StatesDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, United StatesCritical Illness, Brain Dysfunction, and Survivorship Center, Center for Health Services Research, Nashville, TN, United StatesDivision of Anesthesiology Critical Care, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, United StatesCritical Illness, Brain Dysfunction, and Survivorship Center, Center for Health Services Research, Nashville, TN, United StatesGeriatric Research, Education, and Clinical Center Service, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, United StatesCritical Illness, Brain Dysfunction, and Survivorship Center, Center for Health Services Research, Nashville, TN, United StatesDepartment of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United StatesCritical Illness, Brain Dysfunction, and Survivorship Center, Center for Health Services Research, Nashville, TN, United StatesGeriatric Research, Education, and Clinical Center Service, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, United StatesDivision of Allergy, Pulmonary and Critical Care, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United StatesCritical Illness, Brain Dysfunction, and Survivorship Center, Center for Health Services Research, Nashville, TN, United StatesGeriatric Research, Education, and Clinical Center Service, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, United StatesDepartment of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United StatesIntroduction: Catatonia, characterized by motor, behavioral and affective abnormalities, frequently co-occurs with delirium during critical illness. Advanced age is a known risk factor for development of delirium. However, the association between age and catatonia has not been described. We aim to describe the occurrence of catatonia, delirium, and coma by age group in a critically ill, adult population.Design: Convenience cohort, nested within two clinical trials and two observational cohort studies.Setting: Intensive care units in an academic medical center in Nashville, TN.Patients: 378 critically ill adult patients on mechanical ventilation and/or vasopressors.Measurements and Main Results: Patients were assessed for catatonia, delirium, and coma by independent and blinded personnel, the Bush Francis Catatonia Rating Scale, the Confusion Assessment Method for the Intensive Care Unit (ICU) and the Richmond Agitation and Sedation Scale. Of 378 patients, 23% met diagnostic criteria for catatonia, 66% experienced delirium, and 52% experienced coma during the period of observation. There was no relationship found between age and catatonia severity or age and presence of specific catatonia items. The prevalence of catatonia was strongly associated with age in the setting of critical illness (p < 0.05). Delirium and comas' association with age was limited to the setting of catatonia.Conclusion: Given the significant relationship between age and catatonia independent of coma and delirium status, these data demonstrate catatonia's association with advanced age in the setting of critical illness. Future studies can explore the causative factors for this association and further elucidate the risk factors for acute brain dysfunction across the age spectrum.https://www.frontiersin.org/articles/10.3389/fpsyt.2021.673166/fullagecatatoniadeliriumcomacritical illness |
| spellingShingle | Jennifer Connell Jennifer Connell Ahra Kim Nathan E. Brummel Nathan E. Brummel Mayur B. Patel Mayur B. Patel Mayur B. Patel Simon N. Vandekar Pratik Pandharipande Pratik Pandharipande Robert S. Dittus Robert S. Dittus Stephan Heckers Stephan Heckers E. Wes Ely E. Wes Ely E. Wes Ely Jo Ellen Wilson Jo Ellen Wilson Jo Ellen Wilson Advanced Age Is Associated With Catatonia in Critical Illness: Results From the Delirium and Catatonia Prospective Cohort Investigation Frontiers in Psychiatry age catatonia delirium coma critical illness |
| title | Advanced Age Is Associated With Catatonia in Critical Illness: Results From the Delirium and Catatonia Prospective Cohort Investigation |
| title_full | Advanced Age Is Associated With Catatonia in Critical Illness: Results From the Delirium and Catatonia Prospective Cohort Investigation |
| title_fullStr | Advanced Age Is Associated With Catatonia in Critical Illness: Results From the Delirium and Catatonia Prospective Cohort Investigation |
| title_full_unstemmed | Advanced Age Is Associated With Catatonia in Critical Illness: Results From the Delirium and Catatonia Prospective Cohort Investigation |
| title_short | Advanced Age Is Associated With Catatonia in Critical Illness: Results From the Delirium and Catatonia Prospective Cohort Investigation |
| title_sort | advanced age is associated with catatonia in critical illness results from the delirium and catatonia prospective cohort investigation |
| topic | age catatonia delirium coma critical illness |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2021.673166/full |
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