Prospective observational study of dementia and delirium in the acute hospital setting

Travers, C., Byrne, G., Pachana, N., Klein, K. and Gray, Len (2013) Prospective observational study of dementia and delirium in the acute hospital setting. Internal Medicine Journal, 43 3: 262-269. doi:10.1111/j.1445-5994.2012.02962.x


Author Travers, C.
Byrne, G.
Pachana, N.
Klein, K.
Gray, Len
Title Prospective observational study of dementia and delirium in the acute hospital setting
Journal name Internal Medicine Journal   Check publisher's open access policy
ISSN 1444-0903
1445-5994
Publication date 2013-01-01
Year available 2012
Sub-type Article (original research)
DOI 10.1111/j.1445-5994.2012.02962.x
Open Access Status Not yet assessed
Volume 43
Issue 3
Start page 262
End page 269
Total pages 8
Place of publication Wiley-Blackwell Publishing Asia
Publisher Richmond, VIC, Australia
Language eng
Abstract Background Dementia and delirium appear to be common among older patients admitted to acute hospitals, although there are few Australian data regarding these important conditions. Aim The aim of this study was to determine the prevalence and incidence of dementia and delirium among older patients admitted to acute hospitals in Queensland and to profile these patients. Method Prospective observational cohort study (n = 493) of patients aged 70 years and older admitted to general medical, general surgical and orthopaedic wards of four acute hospitals in Queensland between 2008 and 2010. Trained research nurses completed comprehensive geriatric assessments and obtained detailed information about each patient's physical, cognitive and psychosocial functioning using the interRAI Acute Care and other standardised instruments. Nurses also visited patients daily to identify incident delirium. Two physicians independently reviewed patients' medical records and assessments to establish the diagnosis of dementia and/or delirium. Results Overall, 29.4% of patients (n = 145) were considered to have cognitive impairment, including 102 (20.7% of the total) who were considered to have dementia. This rate increased to 47.4% in the oldest patients (aged 90 years). The overall prevalence of delirium at admission was 9.7% (23.5% in patients with dementia), and the rate of incident delirium was 7.6% (14.7% in patients with dementia). Conclusion The prevalence of dementia and delirium among older patients admitted to acute hospitals is high and is likely to increase with population aging. It is suggested that hospital design, staffing and processes should be attuned better to meet these patients' needs.
Formatted abstract
Background
Dementia and delirium appear to be common among older patients admitted to acute hospitals although there are few Australian data regarding these important conditions. The aim of this study was to determine the prevalence and incidence of dementia and delirium among older patients admitted to acute hospitals in Queensland and to profile these patients.

Method

Prospective observational cohort study (n=493) of patients aged 70 years and older admitted to general medical, general surgical and orthopaedic wards of four acute hospitals in Queensland between 2008 and 2010. Trained research nurses completed comprehensive geriatric assessments and obtained detailed information about each patient's physical, cognitive and psychosocial functioning using the interRAI Acute Care and other standardized instruments. Nurses also visited patients daily to identify incident delirium. Two physicians independently reviewed patients’ medical records and assessments to establish the diagnosis of dementia and/or delirium.

Results
Overall, 29.4% of patients (n=145) were considered to have cognitive impairment, including 102 (20.7% of the total) who were considered to have dementia. This rate increased to 47.4% in the oldest patients (aged ≥90 years). The overall prevalence of delirium at admission was 9.7% (23.5% in patients with dementia) and the rate of incident delirium was 7.6% (14.7% in patients with dementia).

Conclusion

The prevalence of dementia and delirium among older patients admitted to acute hospitals is high and is likely to increase with population aging. It is suggested that hospital design, staffing and processes should be attuned to better meet these patients’ needs.
Keyword Aged
Delirium
Dementia
Hospitals
Prevalence
Q-Index Code C1
Q-Index Status Confirmed Code
Grant ID 511125
Institutional Status UQ
Additional Notes Accepted article © 2012 Royal Australasian College of Physicians

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
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Created: Wed, 02 Jan 2013, 21:56:24 EST by Kere Klein on behalf of School of Public Health