A Point Prevalence Study of Delirium in Italian Nursing Homes.

Abstract

BACKGROUND:

Delirium is a common geriatric syndrome. Few studies have been conducted in nursing home (NH) residents. The aim of this project was to perform a point prevalence study of delirium in Italian NHs.

METHODS:

Data collected in 71 NHs are presented. Inclusion criteria were age ≥65 years and native Italian speaker. Exclusion criteria were coma, aphasia, and end-of-life status. Sociodemographic and medical data were recorded. Delirium was assessed using the Assessment Test for Delirium and Cognitive Impairment (4-AT). Patients with a 4-AT score ≥4 were considered to have delirium. Motor subtype was evaluated using the Delirium Motor Subtype Scale (DMSS).

RESULTS:

A total of 1,454 patients were evaluated (mean age 84.4 ± 7.4 years, 70.2% female), of whom 535 (36.8%) had delirium. In multivariate logistic regression analysis, variables significantly associated with delirium were education (OR 0.94, 95% CI 0.91-0.97), dementia (OR 3.12, 95% CI 2.38-4.09), functional dependence (OR 6.13, 95% CI 3.08-12.19 for ADL score 0; OR 1.99, 95% CI 1.03-3.84 for ADL score 1-5), malnutrition (OR 4.87, 95% CI 2.68-8.84), antipsychotics (OR 2.40, 95% CI 1.81-3.18), and physical restraints (OR 2.48, 95% CI 1.71-3.59).

CONCLUSION:

Delirium is common in older NH residents. Simple assessment tools might facilitate its recognition in this vulnerable population.

• Authors: Valeria Morichi, Massimiliano Fedecostante, Alessandro Morandi, Simona Gabriella Di Santo, Andrea Mazzone, Enrico Mossello, Mario Bo, Angelo Bianchetti, Renzo Rozzini, Ermellina Zanetti, Massimo Musicco, Alberto Ferrari, Nicola Ferrara, Marco Trabucchi, Antonio Cherubini, Giuseppe Bellelli, Italian Study Group on Delirium
• Journal: Dementia and geriatric cognitive disorders (Dement Geriatr Cogn Disord) Vol. 46 Issue 1-2 Pg. 27-41 ( 2018) ISSN: 1421-9824 [Electronic] Switzerland
• PMID: 30092581 (Publication Type: Journal Article)
• Copyright: © 2018 S. Karger AG, Basel.

Chemical References

• Antipsychotic Agents

Topics

• Aged
• Aged, 80 and over
• Antipsychotic Agents
• Cognitive Dysfunction (complications)
• Comorbidity
• Cross-Sectional Studies
• Delirium (diagnosis, epidemiology)
• Dementia (diagnosis, epidemiology)
• Geriatric Assessment (statistics & numerical data)
• Humans
• Italy
• Male
• Nursing Homes (statistics & numerical data)
• Psychometrics