The natural history of delirium in older hospitalized patients: a syndrome of heterogeneity.
Reads0
Chats0
TLDR
Delirium in hospitalized older people is common and has a varied presentation and time course, and clinicians and researchers need to consider this great heterogeneity when caring for patients and when studying delirium.Abstract:
Objectives: to determine the presentation, course and duration of delirium in hospitalized older people. Design: observational cohort study. Setting: inpatient surgical and medical wards at a university hospital. Participants: 432 people over the age of 65. Measurements: all participants were screened daily for confusion and, in those who were confused, delirium was ascertained using the Diagnostic and Statistical Manual of Mental Disorders (DSM) HI-R criteria. Those who were found to be delirious were followed daily while in hospital for evidence of delirium. The Delirium Rating Scale (DRS) was used to describe the clinical characteristics of delirium. Results: about 15% of subjects had delirium. Sixty-nine percent of delirious subjects had delirium on a single day. The DRS total was higher on the first day of delirium for those with delirium on multiple days than those with delirium on a single day (/• = 0.03). Among those with delirium on multiple days, there were no patterns of change over time in specific DRS items. Conclusions: delirium in hospitalized older people is common and has a varied presentation and time course. Clinicians and researchers need to consider this great heterogeneity when caring for patients and when studying delirium.read more
Citations
More filters
Journal ArticleDOI
The Delirium Observation Screening Scale: a screening instrument for delirium.
TL;DR: The Delirium Observation Screening (DOS) scale was determined to be content valid and showed high internal consistency and reliability, to guide early recognition of delirium by nurses’ observation.
Journal ArticleDOI
The risk of dementia and death after delirium.
TL;DR: Delirium appears to be an important marker of risk for dementia and death, even in older people without prior cognitive or functional impairment.
Journal ArticleDOI
Delirium in elderly patients.
TL;DR: Although there has been limited progress in understanding the etiology, pathogenesis, assessment, and specific treatment of delirium, systematic detection and treatment programs appear to be beneficial for elderly surgical patients, as are preventive programs for elderly medical and surgical patients.
Journal ArticleDOI
An approach to drug induced delirium in the elderly
TL;DR: An approach for clinicians to prevent, recognise, and manage drug induced delirium is provided and the mechanisms for this condition are reviewed, especially the neurotransmitter imbalances involving acetylcholine, dopamine, and gamma aminobutyric acid.
Journal ArticleDOI
Delirium: optimising management
TL;DR: The development of a clearer definition, improved detection and assessment tools, and recognition of the significant independent morbidity associated with delirium have substantially changed this situation; these developments coupled with a greater awareness of the needs of an increasingly large population of elderly people make a review of the day to day management of patients withDelirium timely.
References
More filters
Journal ArticleDOI
Clarifying Confusion: The Confusion Assessment Method: A New Method for Detection of Delirium
TL;DR: The CAM is sensitive, specific, reliable, and easy to use for identification of delirium and was shown to have convergent agreement with four other mental status tests, including the Mini-Mental State Examination.
Journal ArticleDOI
A Prospective Study of Delirium in Hospitalized Elderly
TL;DR: The increased mortality associated with delirium appears to be explained by greater severity of illness, and identifies elderly at risk for death, longer hospitalization, and institutionalization.
Journal ArticleDOI
A predictive model for delirium in hospitalized elderly medical patients based on admission characteristics.
TL;DR: The focus of this study was to better define host or baseline vulnerability factors that would assist clinicians in identifying, at admission, those patients with a high risk for developing delirium during hospitalization.
Journal ArticleDOI
A symptom rating scale for delirium.
TL;DR: Compared to demented, schizophrenic, and normal control groups, 20 delirious subjects scored significantly higher on the scale, which quantitates multiple parameters affected by delirium.
Journal ArticleDOI
Risk factors for delirium in hospitalized elderly.
Joshua D. Schor,Sue E. Levkoff,Lewis A. Lipsitz,Catherine H. Reilly,Paul D. Cleary,John W. Rowe,Dennis A. Evans +6 more
TL;DR: Delirium in hospitalized patients is most closely associated with factors already present on admission such as prior cognitive impairment, advanced age, and fracture, and in the hospital, use of neuroleptics and narcotics and the presence of infection are less strongly associated with this syndrome.