Dautzenberg_2004_Int.J.Geriatr.Psychiatry_19_641

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.