Rahkonen et al 1 examine the complex issue of outcome after an episode of delirium and, in particular, whether an episode acts as an indicator of undetected dementia. Poor cognitive outcomes, including dementia, are well recognised after delirium but it is unclear whether delirium is merely a marker for dementia or if an episode contributes to the development of enduring cognitive impairment, possibly by a neurotoxic or kindling-type mechansm. Patients with mild cognitive impairment were not excluded at the outset but it is clear that there was a relation between mini mental state examination (MMSE) scores immediately after resolution of DSM IIIR …

Dr T Rahkonen