Delirium in elderly hospitalised patients: protective effects of chronic rivastigmine usage

Objectives To investigate the efficacy of the chronic usage of the cholinesterase inhibitor rivastigmine in patients with dementia in the prevention of delirium in case of hospitalisation. Design Retrospective cohort study. Setting Non-geriatric wards of an 1120 bed general teaching hospital in 's-Hertogenbosch, The Netherlands. Participants Of a group of 366 hospitalised patients, treated by the geriatric consultation team from January 2002 until June 2003, the patients who used rivastigmine chronically were compared with a randomly selected subgroup of all patients not treated with rivastigmine. Measurements The occurrence and duration of a delirium, co-morbidity, use of medication, length of hospitalisation and psychosocial data were collected from the medical charts of the geriatric consultation team. Results 11 patients (3%) were chronic rivastigmine users. A control group of 29 subjects was randomly selected from the non-rivastigmine users of the patient population. In the group that used rivastigmine five patients (45.5%) developed a delirium, compared with 8 (88.9%) in the control group (p < 0.05). Conclusions Chronic rivastigmine use may contribute to the prevention of a delirium in a high-risk group of elderly hospitalised patients suffering from dementia. Copyright (C) 2004 John Wiley Sons, Ltd.