Evidence from dozens of studies of thousands of individuals suggest that as many as half of critical illness survivors experience significant deficits in memory, executive functioning, attention, and processing speed that persist years after discharge from the intensive care unit (ICU). This chapter reviews the prevalence, characteristics, possible mechanisms, and risk factors for long-term cognitive impairment after critical illness. Some key risks factors—notably, delirium—may be modifiable, whereas others, such as genetic markers, are not. Cognitive impairments are associated with psychiatric disorders, including depression, anxiety, and posttraumatic stress disorder. The impact of critical illness–related cognitive impairment on individuals and society includes financial costs, inability to return to work, impairments in instrumental activities of daily living (financial management, medication management, shopping, home care), reduced quality of life, and caregiver burden. Efforts need to be directed not only at modifying risk factors but also at attempting to prevent, treat, and remediate deficits.
Facets of Conscientiousness and risk of dementia
