October 26th, 2010
04:01 PM ET
Severe sepsis can lead to memory problems
Advances in intensive care medicine are helping older Americans survive severe sepsis, an overwhelming infection, but according to new research these survivors are often left with major memory problems and physical limitations for years after their infection.
Researchers presenting their findings in the Journal of the American Medical Association found that even older adults who were functioning independently before sepsis often came home from the hospital needing full time care because they now had pre-dementia.
"If you look at the risk of moderate to severe cognitive impairment, people with severe sepsis were three times more likely to develop that after sepsis than before," says study author Theodore Iwashyna, critical care doctor at the University of Michigan Medical School.
The study monitored the health of more than 1,000 older adults who developed sepsis, comparing their physical and mental capabilities when healthy to those after they got sick. The researchers used data from a study nationally representative of older Americans called the Health and Retirement Study and had access to years of detailed health information on the patients.
Previous research often attributed declines in mental and physical health after sepsis to underlying health problems beforehand. But these researchers, finding that even healthy, mentally sharp adults experienced significant declines, suggest that the sepsis itself and the treatment strategies afterwards may be playing a major role in the downturns in health.
"This new disability that people develop is often associated with 40 hours of care a week. People come home from the hospital after having survived and their loved ones have a new full time job," explains Iwashyna. "Overall 60 percent of people had worse function afterwards than they did before," he adds.
Dr. Derek Angus, chairman of the Department of Critical Care Medicine at the University of Pittsburgh School of Medicine, wrote an accompanying editorial. He has no ties to the current study and says the research may help change current medical practice. "The major advance in this study is it took a concern that was being raised amongst a number of investigators, but a concern that couldn't be proven and has shown this is very likely a real phenomenon," he said.
Severe sepsis is the most common non-heart related reason for a person to end up in a hospital's intensive care unit. More than 750,000 people in the United States are affected by this condition each year, mostly the elderly. Iwashyna says sepsis can develop in patients with a wide range of illnesses such as pneumonia, diabetes, urinary tract infections, those with compromised immune systems and other health problems.
When someone develops sepsis, instead of attacking the infection at the site, the body mounts an overly aggressive immune response and ends up turning on itself, often damaging vital organs such as the heart, lungs and kidneys. If blood pressure drops too drastically doctors suspect the brain and other vital organ don't get enough oxygen to function properly often leaving people physically and mentally impaired.
Iwashyna says more research is needed to develop better treatment strategies for patients with severe sepsis and therapies to minimize the mental and physical impairments seen in patients. In the mean time he suggests people try to prevent the condition by getting pneumonia and flu vaccines and, if diabetic, getting excellent care.
If a loved one does develop sepsis, it's important to talk to your doctor about physical mobility and rehabilitation exercises, but just as importantly, strategies and therapies to help the brain function better.
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I guess this had to be rigidly studied to be proven but to those of us practicing medicine, this is nothing new.
Agreed. I think memory loss is associated with a lot of things that have not yet surfaced. Those "total mouth" dental infections that linger for months and require multiple surgeries, undergoing multiple procedures requiring general anesthesia in close proximity, and others. And age or weak condition may compound it.
Folks should also know that a urinary tract infection (UTI) in an elderly person is akin to sepsis. It will cause dementia-like mental conditions. I've experienced this twice with my mother, age 84.
If only i had known this. in 2008, my best friend had pneumonia-related sepsis. physically she mostly recovered-but something was different, and we both sort of knew it. however-her home health care provider still declined to increase her coverage from the 1.5 hours per day to 3. why? because she wasn't "incontinent". she'd lost the ability to cook her own meals, lost all motivation to leave her apartment, and lost-and this screamed to me- her ability to do crossword puzzles. in the end, another case of sepsis killed her-but not before being left for dead by yet another "one and a half hour and i'm done", poorly-trained worker. if only i'd known about this study: i would never, ever have gone to work that day. able to call 911 if she got "that sick"? no, she wasn't...and no, she didn't. and now i know why.
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Has anyone looked into a new treatment that is finishing up there trials in Europe? The companies name is cytosorbants and it seems to be showing some good results. Maybe this can be a breakthrough in treating sepsis. Let's hope because there are not many options for the patient at this point.
This answered alot of questions I had that my doctors couldn't answer. I went septic on May 3rd, I died twice, the first time I stopped breathing, the second time my heart stopped. They gave me a 1% chance to make it. Now I have had memory problems, I have had to learn my job all over again ( I am a medical transcriptionist), I kept telling people that something was wrong with my memory, but they all just said that it was normal, that they all forget things now and then. I forget little things, I somtimes can't remember how to write my name, or my kids names, b-days etc. Now I know why and thanks to this article will bring it up to my doctor. I am only 46 so I know its not an "age" thing. Thank you for this article.
I am 61 and I had sepsis this year. I keep saying my memory isn't right and yesterday I put together a holiday dinner and while it was very good, it did not come off like I in the past. I forgot to cook things, things I cooked previously, I forgot to put out ... all other years, I usually have it all come together really nicely, but when it was time to eat yesterday I needed help. It all bugged me so much I did google memory and sepsis.
This sheds some light on my issue and I'm not sure what to do about it all yet, but thank you for this article.
I am 53 & I had sepsis while I was in ICU 1 1/2 days & then I was moved to a regular room. I had a temperature if 103.9 shaking uncontrollably and having trouble breathing. Then on top of all the sepsis I was told on mother's day I had MRSA & pneumonia. They sent me home on Monday and I had just been told I had the MRSA on mother's day. They put a port in me on that Saturday & sent me home with it and a lady from home health came out and showed my husband how to flush it and put the antibiotic Cubicin. I had a blow to my head when thrown from a horse in 2008 and I hit my head as I landed on the ground and knocked out. My neighbor saw me thrown from the horse and he said I went soaring in the air. My husband was inside our house and our neighbor went to tell him as his girlfriend stayed with me. My husband said my nose was bleeding and one of my ears had blood coming out of it. I was medflighted and was put in ICU for 4 days & I was not aware of what happened. I didn't know my brother in law or my niece when they came to see me in ICU. My husband, son's and my mother said I was looking at them as if I was trying to figure out who they were. My memory wasn't like it should've been after this. Now since getting Sepsis in May of this year 2015. I had gotten lost several times after my head injury in 2009. Now my memory seems to be worse since May 2015 since I had sepsis. My neurologist sent me to take a neuro psych test. I did the best I could. I just was confused on some of the test. Well I went to my neurologist to get my results from them. Well I was so upset when I arrived at my home after reading my test results. I already was having emotional symptoms like crying and angry outburst, cofusion and struggling for words to say. I know what I'm wanting to say but at times I just can't get it to come out. This lady who gave me the neuropsych test had put down that she couldn't rule out exaggeration! My scores ranged from severely low to low & borderline on the different tests. She has made me look as though I missed some of the questions on purpose! :*( I gave it my best & I have okay days and bad days. I can't tell from one day to the other how my emotions & memory will be. She also made sure she put that I repeated several times that I have memory problems. She also says that I'm trying to get disability. Now that has nothing to do with my issues from the fall or having sepsis. I had to get a total knee replacement on my right knee and my orthopedic doctor recommended that I apply for disability and he supports me in this. He had written this and had his receptionist type it up and said if they have any questions to please call him. He had said that I'd need a sedentary job. I can't stand but so long & the same for sitting. This too varies from day to day as to how long I can stand & sit. I absolutely cannot bend or squat much less get down on the floor to play with my granddaughter. Now my right knee is bone on bone and I need surgery on it now. Another knee replacement. I have degenerative arthritis in my knees & my orthopedic doctor didn't want to do the knee replacement due to my age. He said I was awful still to have it but he also said I have no choice but to have it done because it was deteriorating really bad and fast. So I had it replaced at the age of 47. Now I'm 53 & my right knee is doing exactly what my left had done & now I've been diagnosed with degenerative arthritis in my lower back and spine. Now that is why I decided to see if I would qualify for disability. I had tried when my doctor supported me in getting it but I was turned down twice and I gave up not knowing that when I was turned down the first time in 2009 & the second time in 2011 that all I had to do was go to a disability lawyer. So my husband's cousin took me 18 month's ago to disability lawyers and I now have a hearing soon to determine if I'll get it. So the neuropsych lady who gave me the test has really made it look as though I have no TBI (Traumatic Brain Injury). If she could experience the pain, forgetfulness, trying to say something and not able to find the right words and/or knowing what to say but just can't get the words out, at times I can't even think to write my own name and not remembering my grown two son's birthday, my husband's. The daily struggles are so upsetting to me! Now if she could walk in my shoes she would understand! I go back to my neurologist in November to go over the MRI & Brain scan along with my psych test. I am so very emotional & it has gotten worse since I've gotten out of the hospital and having sepsis. Is it just me or do any others have this problem???? Oh yes! The Neuro lady giving me my test also put down that I was tearful but flat! What in the crap did she mean by that statement!
Shirley (very discouraged)
I am 45 and I had sepsis last year due to pnuemonia. .My memory hasn't been the same since the sepsis .I also used to be a very active person.Now I just want stay home most of the time in my pajamas.I had severe chest pain for the longest time.I still don't sleep on my left side since leaving the hospital and it still hurts alot..I'm tired all of the time and my body hurts.I can't wear most of my clothes or shoes because they feel like weights to me. I am unable to cook and clean much anymore.can't stand long and can't breathe in cleaners. I have severe lung damage and am always short of breath.when I first left the hospital I couldn't hardly dress or toilet myself.I'm doing better now but ?.I feel like my life has been stolen from me and I'm just existing.wondering if life will ever be the same again and so scared it will come back.
I am just now seeing this since my septic shock and sepsis last year. I told the doctor's PA after surgery that something was wrong three times and she never examined me once. I can't remember major transactions and memories that I want to never forget. I should have sued the PA, the doctor and his clinic. She ruined my life. I now have to sell my home and move in with my daughter because I now need care 24/7. I cry constantly at having to sell my home. I am only 60 and now a burden thanks to these people.
So...after reading this article. .
What are the "strategies" to help cognitive decline? Specifically, who can assess and plan for Sepsis shock long term?
I hope someone has some answers for me. I went into the hospital last Oct.31. My symptoms were so bad every time I tried to do my work, I almost passed out 8 times at work.The sepsis also affected my heart. I have memory loss from the sepsis. And it is just getting worse. My PA tells me it's not from the sepsis. It's early stages of dementia. This is aweful not remembering. Can I still be suffering this from sepsis. Please help me.
I went in to have surgery on August third, after a minor surgery I had the week before. When the doctor reopened the previous incision he saw immediately that it was infected. I had a severe case of MRSA. My infectious disesease doctor told me I was probabley the worst patient she has seen in over 30 years. I spent 10 days in the hospital and over a month with a pik line in and nurses coming out several times a week. I had antibiotics sent to me twice a week. I am still on oral antibiotics. Ever since I got the infection, my memory is horrible I forget things alot. Things I used to know right away now it takes me time to remember if possible. I cant even hold a conversation without pausing at some point because I forget what I was saying. I also have some other misc. issues that I never had before all this has happened. I am only 44 and I was always quick on my feet about things but now I feel like 30 years older than I actually am. I am praying that this is all temporary so I can get back my life.
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I went into Severe Septic shock in Dec 2014 – I also had a heart attack in May of that same year – I was placed into a medically induced coma after my husband found me unresponsive Dec 15- 2014 – I was suffering from a UTI – I passed out 911 was called – I was in the coma for 15 days – it was the scariest moment of my life – when I woke up after 15 days – I had no clue why I was in ICU – I thought I totally my car or something but I was given 5% chance of living and in fact my husband was told to call in my family because I may not make it – well 3 1/2 years later I am not the same person – my memory is a joke – I worked a job for 15 years – started having panic attacks about leaving my home – totaled my car in 2015 – had right rotator surgery in 2016 – but over all I truly as not the same person I was before the Severe Septic shock – my life will never be the same
In December 2017 I went to the hospital in severe stomach pain I could not even walk I was admitted all of a sudden I couldn’t breathe after several hours I went into congestive heart failure I was transferred to the ICU unit placed on life support for five days I was not expected to live as I got worse my family was told I had to be sent for surgery I had a huge gaulstone in the bowel duck between the liver and gaulbladder emergency surgery was done I was returned to ICU three days later I went back to surgery to complete the surgery to remove the other gaulstones and gaulblader after five days i went to step down for 12 days when released i had home health and physical therapy for three months i recovered good physically but my brain and memory has not it seems to get worse all the time any suggestions please text me
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I am 57 years old. I contracted flu in December. Turned into pnemonia and within 6 days of getting sick I went into septic shock. I remember my BP was very low (68/48) and I had 4 IVs in the ER. One was femoral IV to get my BP up. My BP could have been worse than that but they either didn't tell me or I forgot.
My GP repeatedly told me I almost died. I was in ICU for two days and hospital for 5.
Ever since then my brain doesn't seem to work right. And for sure not like it used to. Now I have worsening memory problems, I have to work hard to focus on tasks. If I get interrupted or distracted, it's over. Sometimes I can't remember or can't figure out how to do something. Even typing this is challenging with going back and forth on capitalzation, numbers, alphabet and alphabet, itself, screen. I used to type 60WPM, but sometimes can't remember where a letter is on the keyboard. Thank God for predict text. Plus I'm trying not to forget anything in this very long dissertation. I feel like "I used to be smart."
I now have an even bigger problem with going from task to task to task without completing them. I can't seem to connect the dots sometimes. My short term memory is getting worse. I sometimes can't find the word I want to say or forget altogether what I want to say or what my point was. (I went over this MANY times and made many changes before publishing!)
I've repeatedly told my hubby something isn't right and I wondered if it had to do with that incident of septic shock and sepsis.
Also, in February one of my new doctors (from parathyroid issue) decided to change my depression med from effexor to viibryd. After 5 or so weeks my hair started falling out. (Thinking about it now, maybe that was due to trauma I suffered from being so sick. Hmmm.)
So, when I went to my psychiatrist we discussed doing another med change from viibryd to welbutrin. So, I think that med changes are exasperbating the situation.
Today I had an incident happen because of my brain inadequacy.
So, I did Dr Google and found your article among others.
I feel much better knowing that I am not crazy in my thinking that something is wrong.
So, all that to say (and it took me about an hour, or so, for me to get this done) Thank you for your article!
I am 69, Australian, relatively fit and also used Dr Google to find out about brain dysfunction after sepsis. A bit of background to make my tale a bit more understandable:
I started studying again about 4 years ago (and completing 3 years later) an accounting degree because I was driving my wife to distraction and I had to do something. Shortly after starting the degree I moved over to a LCHF diet which included making a switch from beer to red wine My grades improved from a GPA of 2 (60 to 70%) to > 3 (actually 77%) as my brain became more lucid with the elimination of carbs and attendant sugars. At he beginning of this year I started a Graduate Tax Degree.
Mid May this year I was shovelling compost and throwing this onto a bonfire in the paddock. 5 days later I was in ICU and when I had respiratory failure as well as having organ failure I was placed into an induced coma for 8 days. All in all I spent 12 days in ICU and a month in hospital, mainly in the rehab ward. I was allowed home because my wife is a RN. About the beginning of July I had a full spectrum blood analysis, our doctor actually said "remarkable" because these all came back excellent. I think I chucked the walking stick on the 2nd day home.
Then I had to check whether I had brain impairment so I wrote the Graduate Certificate Tax exam in mid July.I was still a bit stuffed from the ordeal. I passed but my descriptive works (law and international tax) were a scrape (55%) yet the calculating components (applied tax and finance) were normal at around 77% pass. I will continue next year and hopefully gain my Masters then.
Apart from that I have started to exercise strongly but can only get back to having a glass of red in mid August because my Pancreas was compromised during the organ failure episodes.
I cannot attribute any real reason to overcoming sepsis so well...LCHF – possibly? I do not think the Drs caught on it being sepsis particularly quickly and I was probably median in treatment regimes. Luck? Previous fitness? Who knows.
Good recovery to all you guys – Owen
Hi, just read this article. It is very useful. My Daughter who had suffered severe sepsis at birth in 2004. She developed sepsis within 3 hours immediately after delivery and had been kept in neonatal ward for 10days with lots of machines and tubes in and around her. The doctors treated her told us she will not make it. I thank GOD She is 15years old now and she is physically fit, living a normal life. But when she was young she used to ask the same questions repeatedly and tend to forget next minute. That time I really don’t know the reason behind her act. I don’t have much knowledge about sepsis and it’s effects. But when she grow older and started her schooling problem started. She tend to forget things very often. Once she took wrong school bus to come home. It’s scared me a lot. She is in secondary school now and I need to hear a lot of complaints from school tearchers that she had been forgetting to pass her homework etc...since young until today. She couldn’t get good grades even though she prepare well for her exams because of her. It is really a heart aching for me and for my Daughter. I really tried many ways to support her forgetfulness but at times I scolded her also to remember things. Constant reminders were given to her to remember things. Because of the forgetfulness she need to face a lot of humiliation at school and other places. After reading this article knowing that spesis could cause brain damage that leads to forgetfulness. I will definitely find strategies to help her succeed in her life.
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