Prevalence and management of delirium in community dwelling older people with dementia referred to a memory clinic
- PDF / 485,797 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 48 Downloads / 159 Views
ORIGINAL ARTICLE
Prevalence and management of delirium in community dwelling older people with dementia referred to a memory clinic Barbara Manni1 · Lucia Federzoni1 · Patrizia Zucchi1 · Chiara Mussi2 · Marco Inzitari3 · Cristina Arnal Carda3 · Andrea Fabbo1 · Alessandro Morandi3,4 Received: 24 July 2020 / Accepted: 30 October 2020 © Springer Nature Switzerland AG 2020
Abstract Objective Our aim was to measure the prevalence of delirium, its clinical features, and outcomes in older patients referred to a memory clinic. Methods A retrospective cohort study of 109 older outpatients with delirium referred to a memory clinic with a home care service. Delirium was diagnosed using the confusion assessment method and dementia with the DSM-5 criteria. We collected information on cognitive and functional status, mortality, institutionalization, and hospitalization during 6 months following the delirium episode. Results Delirium prevalence was 3.6%, mostly of hyperactive type. Delirium worsened functional (ADL 2.95 ± 1.95 vs. 2.16 ± 1.84) and cognitive (MMSE 13.88 ± 8.96 vs.11.0 ± 9.49) status after 6 months compared to the baseline. The mortality rate was 29.4%, and 28.3% were admitted to a long-term facility after the episode of delirium. Of these patients, more than half were hospitalized during the follow-up. Of the 109 patients with delirium, 85 were managed at home and 24 were hospitalized. Patients who were hospitalized had more severe behavioral symptoms during the delirium episode. There was no difference in mortality and institutionalization according to the home or hospital management. Conclusions This retrospective cohort study adds novel information to the existing literature of an understudied setting and population. The study supports the need to further investigate the feasibility and efficacy of the hospital at home models for the prevention and management of delirium in a high-risk population. Keywords Delirium · Home care · Dementia
Introduction Delirium is defined as an acute disturbance in attention and cognition that develops over a short period of time and is caused by an underlying clinical condition. Delirium * Alessandro Morandi [email protected] 1
Cognitive Disorders and Dementia Unit, Modena Health Authority and Services, Primary Care, Modena, Italy
2
Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
3
REFiT Bcn Research Group, ParcSanitari Pere Virgili and Valld’Hebrón Institute of Research, Barcelona, Spain
4
Department of Rehabilitation and Aged Care “Fondazione Camplani” Hospital, Hospital Ancelle, Via Aselli 14, 26100 Cremona, Italy
prevalence in the acute hospital ranges from 17 to 50% according to the settings [1]. The occurrence of delirium is associated with adverse outcomes including increased hospital costs, mortality, dementia and worsening of dementia and functional decline [2–5]. Additionally, it has been shown that delirium is a stressful event for the patients and the caregi
Data Loading...
