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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Auteurs principaux:	Jennifer Connell, Ahra Kim, Nathan E. Brummel, Mayur B. Patel, Simon N. Vandekar, Pratik Pandharipande, Robert S. Dittus, Stephan Heckers, E. Wes Ely, Jo Ellen Wilson
Format:	article
Langue:	EN
Publié:	Frontiers Media S.A. 2021
Sujets:	age catatonia delirium coma critical illness Psychiatry RC435-571
Accès en ligne:	https://doaj.org/article/ca8c1f6ed7174d3fa315356f53652a82
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spelling	oai:doaj.org-article:ca8c1f6ed7174d3fa315356f53652a822021-11-19T04:48:16ZAdvanced Age Is Associated With Catatonia in Critical Illness: Results From the Delirium and Catatonia Prospective Cohort Investigation1664-064010.3389/fpsyt.2021.673166https://doaj.org/article/ca8c1f6ed7174d3fa315356f53652a822021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fpsyt.2021.673166/fullhttps://doaj.org/toc/1664-0640Introduction: 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.Jennifer ConnellJennifer ConnellAhra KimNathan E. BrummelNathan E. BrummelMayur B. PatelMayur B. PatelMayur B. PatelSimon N. VandekarPratik PandharipandePratik PandharipandeRobert S. DittusRobert S. DittusStephan HeckersStephan HeckersE. Wes ElyE. Wes ElyE. Wes ElyJo Ellen WilsonJo Ellen WilsonJo Ellen WilsonFrontiers Media S.A.articleagecatatoniadeliriumcomacritical illnessPsychiatryRC435-571ENFrontiers in Psychiatry, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	age catatonia delirium coma critical illness Psychiatry RC435-571
spellingShingle	age catatonia delirium coma critical illness Psychiatry RC435-571 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
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.
format	article
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
title	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_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_sort	advanced age is associated with catatonia in critical illness: results from the delirium and catatonia prospective cohort investigation
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/ca8c1f6ed7174d3fa315356f53652a82
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Advanced Age Is Associated With Catatonia in Critical Illness: Results From the Delirium and Catatonia Prospective Cohort Investigation

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