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Delirium occurrence in older Irish adults admitted to an acute medical hospital: a prospective cohort study

Published online by Cambridge University Press:  18 January 2021

C. Dolan*
Affiliation:
Sligo Leitrim Mental Health Services, Ballytivnan, Sligo, Ireland
M. Mohd Zubir
Affiliation:
Sligo Leitrim Mental Health Services, Ballytivnan, Sligo, Ireland
V. Melvin
Affiliation:
Sligo Leitrim Mental Health Services, Ballytivnan, Sligo, Ireland
G. McCarthy
Affiliation:
Sligo Leitrim Mental Health Services, Ballytivnan, Sligo, Ireland Sligo Medical Academy, NUI Galway, The Mall, Rathquarter, Sligo, Ireland
D. Meagher
Affiliation:
Cognitive Impairment Research Group (CIRG), Graduate Entry Medical School, University of Limerick, Limerick, Ireland
D. Adamis
Affiliation:
Sligo Leitrim Mental Health Services, Ballytivnan, Sligo, Ireland
*
*Address for correspondence: Dr C. Dolan, Consultant Psychiatry of Old Age, Liscarney House, Pearse Road, Sligo, Ireland. (Email: catherine.dolan1@hse.ie)

Abstract

Objectives

Delirium, which is associated with adverse health outcomes, is poorly detected in hospital settings. This study aimed to determine delirium occurrence among older medical inpatients and to capture associated risk factors.

Methods

This prospective cohort study was performed at an Irish University Hospital. Medical inpatients 70 years and over were included. Baseline assessments within 72 hours of admission included delirium status and severity as determined by the Revised Delirium Rating Scale (DRS-R-98), cognition, physical illness severity and physical functioning. Pre-existing cognitive impairment was determined with Short Informant Questionnaire on Cognitive Decline (IQCODE). Serial assessment of delirium status, cognition and the physical illness severity were undertaken every 3 (±1) days during participants’ hospital admission.

Results

Of 198 study participants, 92 (46.5%) were women and mean age was 80.6 years (s.d. 6.81; range 70–97). Using DRS-R-98, 17.7% (n = 35) had delirium on admission and 11.6% (n = 23) had new-onset delirium during admission. In regression analysis, older age, impaired cognition and lower functional ability at admission were associated with a significant likelihood of delirium.

Conclusions

In this study, almost one-third of older medical inpatients in an acute hospital had delirium during admission. Findings that increasing age, impaired cognition and lower functional ability at admission were associated with increased delirium risk suggest target groups for enhanced delirium detection and prevention strategies. This may improve clinical outcomes.

Type
Original Research
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The College of Psychiatrists of Ireland

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