Delirium in older hospitalized patients-A prospective analysis of the detailed course of delirium in geriatric inpatients
Delirium in older hospitalized patients (> 65) is a common clinical syndrome, which is frequently unrecognized. We aimed to describe the detailed clinical course of delirium and related cognitive functioning in geriatric patients in a mainly non-postoperative setting in association with demograph...
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| creator | Wilke, Skadi Steiger, Edgar Bärwolff, Tanja L Kleine, Justus F Müller-Werdan, Ursula Rosada, Adrian |
| description | Delirium in older hospitalized patients (> 65) is a common clinical syndrome, which is frequently unrecognized.
We aimed to describe the detailed clinical course of delirium and related cognitive functioning in geriatric patients in a mainly non-postoperative setting in association with demographic and clinical parameters and additionally to identify risk factors for delirium in this common setting.
Inpatients of a geriatric ward were screened for delirium and in the case of presence of delirium included into the study. Patients received three assessments including Mini-Mental-Status-Examination (MMSE) and the Delirium Rating Scale Revised 98 (DRS-R-98). We conducted correlation and linear mixed-effects model analyses to detect associations.
Overall 31 patients (82 years (mean)) met the criteria for delirium and were included in the prospective observational study. Within one week of treatment, mean delirium symptom severity fell below the predefined cut-off. While overall cognitive functioning improved over time, short- and long-term memory deficits remained. Neuroradiological conspicuities were associated with cognitive deficits, but not with delirium severity.
The temporal stability of some delirium symptoms (short-/long-term memory, language) on the one hand and on the other hand decrease in others (hallucinations, orientation) shown in our study visualizes the heterogeneity of symptoms attributed to delirium and their different courses, which complicates the differentiation between delirium and a preexisting cognitive decline. The recovery from delirium seems to be independent of preclinical cognitive status.
Treatment of the acute medical condition is associated with a fast decrease in delirium severity. Given the high incidence and prevalence of delirium in hospitalized older patients and its detrimental impact on cognition, abilities and personal independence further research needs to be done. |
| doi_str_mv | 10.1371/journal.pone.0279763 |
| format | Article |
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We aimed to describe the detailed clinical course of delirium and related cognitive functioning in geriatric patients in a mainly non-postoperative setting in association with demographic and clinical parameters and additionally to identify risk factors for delirium in this common setting.
Inpatients of a geriatric ward were screened for delirium and in the case of presence of delirium included into the study. Patients received three assessments including Mini-Mental-Status-Examination (MMSE) and the Delirium Rating Scale Revised 98 (DRS-R-98). We conducted correlation and linear mixed-effects model analyses to detect associations.
Overall 31 patients (82 years (mean)) met the criteria for delirium and were included in the prospective observational study. Within one week of treatment, mean delirium symptom severity fell below the predefined cut-off. While overall cognitive functioning improved over time, short- and long-term memory deficits remained. Neuroradiological conspicuities were associated with cognitive deficits, but not with delirium severity.
The temporal stability of some delirium symptoms (short-/long-term memory, language) on the one hand and on the other hand decrease in others (hallucinations, orientation) shown in our study visualizes the heterogeneity of symptoms attributed to delirium and their different courses, which complicates the differentiation between delirium and a preexisting cognitive decline. The recovery from delirium seems to be independent of preclinical cognitive status.
Treatment of the acute medical condition is associated with a fast decrease in delirium severity. Given the high incidence and prevalence of delirium in hospitalized older patients and its detrimental impact on cognition, abilities and personal independence further research needs to be done.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0279763</identifier><identifier>PMID: 36928887</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Activities of daily living ; Aged ; Biology and Life Sciences ; Brain research ; Care and treatment ; Cognition ; Cognition Disorders - complications ; Cognitive ability ; Cognitive Dysfunction - complications ; Delirium ; Delirium - etiology ; Dementia ; Demographic aspects ; Diagnosis ; Geriatric Assessment ; Geriatrics ; Hallucinations ; Health services ; Heterogeneity ; Hospital patients ; Hospitalization ; Humans ; Inpatients ; Laboratories ; Long term memory ; Medical imaging ; Medical records ; Medicine and Health Sciences ; Memory ; Mental disorders ; Neuroimaging ; Parameter identification ; Patients ; Psychologists ; Research and Analysis Methods ; Risk Factors ; Social Sciences</subject><ispartof>PloS one, 2023-03, Vol.18 (3), p.e0279763-e0279763</ispartof><rights>Copyright: © 2023 Wilke et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2023 Public Library of Science</rights><rights>2023 Wilke et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 Wilke et al 2023 Wilke et al</rights><rights>2023 Wilke et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c642t-3639ecd4ec9b787971cf8a1b6e1b045e47321d20cd4be3b8deab3a53b7faa7f93</cites><orcidid>0000-0002-8646-4185 ; 0000-0002-9937-4007</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10019648/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10019648/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36928887$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Hori, Hikaru</contributor><creatorcontrib>Wilke, Skadi</creatorcontrib><creatorcontrib>Steiger, Edgar</creatorcontrib><creatorcontrib>Bärwolff, Tanja L</creatorcontrib><creatorcontrib>Kleine, Justus F</creatorcontrib><creatorcontrib>Müller-Werdan, Ursula</creatorcontrib><creatorcontrib>Rosada, Adrian</creatorcontrib><title>Delirium in older hospitalized patients-A prospective analysis of the detailed course of delirium in geriatric inpatients</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Delirium in older hospitalized patients (> 65) is a common clinical syndrome, which is frequently unrecognized.
We aimed to describe the detailed clinical course of delirium and related cognitive functioning in geriatric patients in a mainly non-postoperative setting in association with demographic and clinical parameters and additionally to identify risk factors for delirium in this common setting.
Inpatients of a geriatric ward were screened for delirium and in the case of presence of delirium included into the study. Patients received three assessments including Mini-Mental-Status-Examination (MMSE) and the Delirium Rating Scale Revised 98 (DRS-R-98). We conducted correlation and linear mixed-effects model analyses to detect associations.
Overall 31 patients (82 years (mean)) met the criteria for delirium and were included in the prospective observational study. Within one week of treatment, mean delirium symptom severity fell below the predefined cut-off. While overall cognitive functioning improved over time, short- and long-term memory deficits remained. Neuroradiological conspicuities were associated with cognitive deficits, but not with delirium severity.
The temporal stability of some delirium symptoms (short-/long-term memory, language) on the one hand and on the other hand decrease in others (hallucinations, orientation) shown in our study visualizes the heterogeneity of symptoms attributed to delirium and their different courses, which complicates the differentiation between delirium and a preexisting cognitive decline. The recovery from delirium seems to be independent of preclinical cognitive status.
Treatment of the acute medical condition is associated with a fast decrease in delirium severity. Given the high incidence and prevalence of delirium in hospitalized older patients and its detrimental impact on cognition, abilities and personal independence further research needs to be done.</description><subject>Activities of daily living</subject><subject>Aged</subject><subject>Biology and Life Sciences</subject><subject>Brain research</subject><subject>Care and treatment</subject><subject>Cognition</subject><subject>Cognition Disorders - complications</subject><subject>Cognitive ability</subject><subject>Cognitive Dysfunction - complications</subject><subject>Delirium</subject><subject>Delirium - etiology</subject><subject>Dementia</subject><subject>Demographic aspects</subject><subject>Diagnosis</subject><subject>Geriatric Assessment</subject><subject>Geriatrics</subject><subject>Hallucinations</subject><subject>Health services</subject><subject>Heterogeneity</subject><subject>Hospital 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Hikaru</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Delirium in older hospitalized patients-A prospective analysis of the detailed course of delirium in geriatric inpatients</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2023-03-16</date><risdate>2023</risdate><volume>18</volume><issue>3</issue><spage>e0279763</spage><epage>e0279763</epage><pages>e0279763-e0279763</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Delirium in older hospitalized patients (> 65) is a common clinical syndrome, which is frequently unrecognized.
We aimed to describe the detailed clinical course of delirium and related cognitive functioning in geriatric patients in a mainly non-postoperative setting in association with demographic and clinical parameters and additionally to identify risk factors for delirium in this common setting.
Inpatients of a geriatric ward were screened for delirium and in the case of presence of delirium included into the study. Patients received three assessments including Mini-Mental-Status-Examination (MMSE) and the Delirium Rating Scale Revised 98 (DRS-R-98). We conducted correlation and linear mixed-effects model analyses to detect associations.
Overall 31 patients (82 years (mean)) met the criteria for delirium and were included in the prospective observational study. Within one week of treatment, mean delirium symptom severity fell below the predefined cut-off. While overall cognitive functioning improved over time, short- and long-term memory deficits remained. Neuroradiological conspicuities were associated with cognitive deficits, but not with delirium severity.
The temporal stability of some delirium symptoms (short-/long-term memory, language) on the one hand and on the other hand decrease in others (hallucinations, orientation) shown in our study visualizes the heterogeneity of symptoms attributed to delirium and their different courses, which complicates the differentiation between delirium and a preexisting cognitive decline. The recovery from delirium seems to be independent of preclinical cognitive status.
Treatment of the acute medical condition is associated with a fast decrease in delirium severity. Given the high incidence and prevalence of delirium in hospitalized older patients and its detrimental impact on cognition, abilities and personal independence further research needs to be done.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>36928887</pmid><doi>10.1371/journal.pone.0279763</doi><tpages>e0279763</tpages><orcidid>https://orcid.org/0000-0002-8646-4185</orcidid><orcidid>https://orcid.org/0000-0002-9937-4007</orcidid><oa>free_for_read</oa></addata></record> |
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| issn | 1932-6203 1932-6203 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Activities of daily living Aged Biology and Life Sciences Brain research Care and treatment Cognition Cognition Disorders - complications Cognitive ability Cognitive Dysfunction - complications Delirium Delirium - etiology Dementia Demographic aspects Diagnosis Geriatric Assessment Geriatrics Hallucinations Health services Heterogeneity Hospital patients Hospitalization Humans Inpatients Laboratories Long term memory Medical imaging Medical records Medicine and Health Sciences Memory Mental disorders Neuroimaging Parameter identification Patients Psychologists Research and Analysis Methods Risk Factors Social Sciences |
| title | Delirium in older hospitalized patients-A prospective analysis of the detailed course of delirium in geriatric inpatients |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-05T12%3A48%3A55IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Delirium%20in%20older%20hospitalized%20patients-A%20prospective%20analysis%20of%20the%20detailed%20course%20of%20delirium%20in%20geriatric%20inpatients&rft.jtitle=PloS%20one&rft.au=Wilke,%20Skadi&rft.date=2023-03-16&rft.volume=18&rft.issue=3&rft.spage=e0279763&rft.epage=e0279763&rft.pages=e0279763-e0279763&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0279763&rft_dat=%3Cgale_plos_%3EA741535662%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2787586476&rft_id=info:pmid/36928887&rft_galeid=A741535662&rft_doaj_id=oai_doaj_org_article_ce9ff526159e4ca795db8b9ce3d6b53d&rfr_iscdi=true |