Abstract Background Delirium is a common, preventable hospital complication and a recognised risk factor for cognitive decline, but its association with both the risk and timing of nursing home admission remains uncertain, particularly in relation to dementia. Methods We conducted a matched cohort study of hospitalised UK Biobank participants with linked hospital records (1997–2022). Episodes of delirium were identified using ICD-10 codes and matched 1:1 to non-delirium control episodes within no dementia (n = 13 004) and dementia (n = 1790) groups. Matching was performed on age, sex, hospital frailty risk score, primary diagnosis, length of stay and intensive care admission. Incident nursing home admissions were identified from hospital discharge records. Fine–Gray models estimated adjusted subdistribution hazard ratios (SHRs), while accelerated failure-time models quantified time to admission. Results Delirium was associated with a higher risk of nursing home admission in participants without dementia (SHR 1.23, 95% CI 1.14–1.34) and with pre-existing dementia (SHR 1.22, 95% CI 1.07–1.38). Delirium also precipitated admission by ~40% in both groups, corresponding to 1.6 years earlier (95% CI 1.1–1.9) at a survival probability of 0.90 in those without dementia and 1.3 years earlier (95% CI 0.6–1.8) at a survival probability of 0.70 in those with dementia. Conclusions Hospital-recorded delirium was associated with both if and when older adults entered nursing home care. In contrast to previous evidence, this association was present regardless of pre-existing dementia. These findings highlight delirium prevention as a potential strategy to delay—or avert—transitions to long-term care.
Haapanen et al. (Fri,) studied this question.