Functional and cognitive decline in older delirious adults after an emergency department visit
Abstract Background the aim of this study was to evaluate the impact of emergency department (ED) stay-associated delirium on older patient’s functional and cognitive status at 60 days post ED visit. Methods this study was part of the multi-centre prospective cohort INDEED study. This project took p...
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| Veröffentlicht in: | Age and ageing 2021-01, Vol.50 (1), p.135-140 |
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| creator | Giroux, Marianne Émond, Marcel Nadeau, Alexandra Boucher, Valérie Carmichael, Pierre-Hugues Voyer, Philippe Pelletier, Mathieu Gouin, Émilie Daoust, Raoul Berthelot, Simon Lamontagne, Marie-Eve Morin, Michèle Lemire, Stéphane Sirois, Marie-Josée |
| description | Abstract
Background
the aim of this study was to evaluate the impact of emergency department (ED) stay-associated delirium on older patient’s functional and cognitive status at 60 days post ED visit.
Methods
this study was part of the multi-centre prospective cohort INDEED study. This project took place between March 2015 and July 2016 in five participating EDs across the province of Quebec. Independent non-delirious patients aged ≥65, with an ED stay ≥8 hours, were monitored for delirium until 24 hours post ward admission. A 60-day follow-up phone assessment was conducted. Participants were screened for delirium using the Confusion Assessment Method. Functional and cognitive statuses were assessed at baseline and at the 60-day follow-up using OARS and TICS-m.
Results
a total of 608 patients were recruited, 393 of which completed the 60-day follow-up. The Confusion Assessment Method was positive in 69 patients (11.8%) during ED stay or within the first 24 hours following ward admission. At 60 days, delirium patients experienced an adjusted loss of −2.9/28 [95%CI: −3.9, −2.0] points on the OARS scale compared to non-delirious patients who lost −1.6 [95%CI: −1.9, −1.3] (P = 0.006). A significant adjusted difference in cognitive function was also noted at 60 days, as TICS-m scores in delirious patients decreased by −1.6 [95%CI: −3.5, 0.2] compared to non-delirious patients, who showed a minor improvement of 0.5 [95%CI: −0.1, 1.1] (P = 0.03).
Conclusion
seniors who developed ED stay-associated delirium have lower baseline functional and cognitive status than non-delirious patients, and they will experience a more significant decline at 60 days post ED visit. |
| doi_str_mv | 10.1093/ageing/afaa128 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2440901823</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ageing/afaa128</oup_id><sourcerecordid>2440901823</sourcerecordid><originalsourceid>FETCH-LOGICAL-c397t-88a4ca91e74bfff784e37efb9307512a9edefd81125f7ec99f0ba027f3974ace3</originalsourceid><addsrcrecordid>eNqFkEFLAzEQRoMotlavHmXBix62TbJpkxxFrAqCF726TLOTEtnN1iQr9N8bafXgxdOQ4c2XmUfIOaNTRnU1gzU6v56BBWBcHZAxEwtVclWJQzKmlPKSSq5H5CTG9_xkc8aPyajiSgsp1Ji8LQdvkus9tAX4pjD92rvkPrFo0LTOY-F80bcNhtxoXXD9EAtohjblYlNugy-ww7BGb7aZ2UBIHfpUfLro0ik5stBGPNvXCXld3r3cPpRPz_ePtzdPpam0TKVSIAxohlKsrLVSCawk2pWuqMwbg8YGbaMY43Mr0Wht6QoolzZPCzBYTcjVLncT-o8BY6o7Fw22LXjMG9dcCKopU7zK6OUf9L0fQr7_m8o_L_Q865uQ6Y4yoY8xoK03wXUQtjWj9bf5eme-3pvPAxf72GHVYfOL_6jOwPUO6IfNf2FfOW-QcA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2478469528</pqid></control><display><type>article</type><title>Functional and cognitive decline in older delirious adults after an emergency department visit</title><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Giroux, Marianne ; Émond, Marcel ; Nadeau, Alexandra ; Boucher, Valérie ; Carmichael, Pierre-Hugues ; Voyer, Philippe ; Pelletier, Mathieu ; Gouin, Émilie ; Daoust, Raoul ; Berthelot, Simon ; Lamontagne, Marie-Eve ; Morin, Michèle ; Lemire, Stéphane ; Sirois, Marie-Josée</creator><creatorcontrib>Giroux, Marianne ; Émond, Marcel ; Nadeau, Alexandra ; Boucher, Valérie ; Carmichael, Pierre-Hugues ; Voyer, Philippe ; Pelletier, Mathieu ; Gouin, Émilie ; Daoust, Raoul ; Berthelot, Simon ; Lamontagne, Marie-Eve ; Morin, Michèle ; Lemire, Stéphane ; Sirois, Marie-Josée</creatorcontrib><description>Abstract
Background
the aim of this study was to evaluate the impact of emergency department (ED) stay-associated delirium on older patient’s functional and cognitive status at 60 days post ED visit.
Methods
this study was part of the multi-centre prospective cohort INDEED study. This project took place between March 2015 and July 2016 in five participating EDs across the province of Quebec. Independent non-delirious patients aged ≥65, with an ED stay ≥8 hours, were monitored for delirium until 24 hours post ward admission. A 60-day follow-up phone assessment was conducted. Participants were screened for delirium using the Confusion Assessment Method. Functional and cognitive statuses were assessed at baseline and at the 60-day follow-up using OARS and TICS-m.
Results
a total of 608 patients were recruited, 393 of which completed the 60-day follow-up. The Confusion Assessment Method was positive in 69 patients (11.8%) during ED stay or within the first 24 hours following ward admission. At 60 days, delirium patients experienced an adjusted loss of −2.9/28 [95%CI: −3.9, −2.0] points on the OARS scale compared to non-delirious patients who lost −1.6 [95%CI: −1.9, −1.3] (P = 0.006). A significant adjusted difference in cognitive function was also noted at 60 days, as TICS-m scores in delirious patients decreased by −1.6 [95%CI: −3.5, 0.2] compared to non-delirious patients, who showed a minor improvement of 0.5 [95%CI: −0.1, 1.1] (P = 0.03).
Conclusion
seniors who developed ED stay-associated delirium have lower baseline functional and cognitive status than non-delirious patients, and they will experience a more significant decline at 60 days post ED visit.</description><identifier>ISSN: 0002-0729</identifier><identifier>EISSN: 1468-2834</identifier><identifier>DOI: 10.1093/ageing/afaa128</identifier><identifier>PMID: 32894748</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Cognitive ability ; Cognitive functioning ; Cognitive impairment ; Confusion ; Delirium ; Emergency medical care ; Emergency services ; Evaluation ; Older people ; Tics</subject><ispartof>Age and ageing, 2021-01, Vol.50 (1), p.135-140</ispartof><rights>The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com 2020</rights><rights>The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.</rights><rights>The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c397t-88a4ca91e74bfff784e37efb9307512a9edefd81125f7ec99f0ba027f3974ace3</citedby><cites>FETCH-LOGICAL-c397t-88a4ca91e74bfff784e37efb9307512a9edefd81125f7ec99f0ba027f3974ace3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1584,27924,27925,30999</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32894748$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Giroux, Marianne</creatorcontrib><creatorcontrib>Émond, Marcel</creatorcontrib><creatorcontrib>Nadeau, Alexandra</creatorcontrib><creatorcontrib>Boucher, Valérie</creatorcontrib><creatorcontrib>Carmichael, Pierre-Hugues</creatorcontrib><creatorcontrib>Voyer, Philippe</creatorcontrib><creatorcontrib>Pelletier, Mathieu</creatorcontrib><creatorcontrib>Gouin, Émilie</creatorcontrib><creatorcontrib>Daoust, Raoul</creatorcontrib><creatorcontrib>Berthelot, Simon</creatorcontrib><creatorcontrib>Lamontagne, Marie-Eve</creatorcontrib><creatorcontrib>Morin, Michèle</creatorcontrib><creatorcontrib>Lemire, Stéphane</creatorcontrib><creatorcontrib>Sirois, Marie-Josée</creatorcontrib><title>Functional and cognitive decline in older delirious adults after an emergency department visit</title><title>Age and ageing</title><addtitle>Age Ageing</addtitle><description>Abstract
Background
the aim of this study was to evaluate the impact of emergency department (ED) stay-associated delirium on older patient’s functional and cognitive status at 60 days post ED visit.
Methods
this study was part of the multi-centre prospective cohort INDEED study. This project took place between March 2015 and July 2016 in five participating EDs across the province of Quebec. Independent non-delirious patients aged ≥65, with an ED stay ≥8 hours, were monitored for delirium until 24 hours post ward admission. A 60-day follow-up phone assessment was conducted. Participants were screened for delirium using the Confusion Assessment Method. Functional and cognitive statuses were assessed at baseline and at the 60-day follow-up using OARS and TICS-m.
Results
a total of 608 patients were recruited, 393 of which completed the 60-day follow-up. The Confusion Assessment Method was positive in 69 patients (11.8%) during ED stay or within the first 24 hours following ward admission. At 60 days, delirium patients experienced an adjusted loss of −2.9/28 [95%CI: −3.9, −2.0] points on the OARS scale compared to non-delirious patients who lost −1.6 [95%CI: −1.9, −1.3] (P = 0.006). A significant adjusted difference in cognitive function was also noted at 60 days, as TICS-m scores in delirious patients decreased by −1.6 [95%CI: −3.5, 0.2] compared to non-delirious patients, who showed a minor improvement of 0.5 [95%CI: −0.1, 1.1] (P = 0.03).
Conclusion
seniors who developed ED stay-associated delirium have lower baseline functional and cognitive status than non-delirious patients, and they will experience a more significant decline at 60 days post ED visit.</description><subject>Cognitive ability</subject><subject>Cognitive functioning</subject><subject>Cognitive impairment</subject><subject>Confusion</subject><subject>Delirium</subject><subject>Emergency medical care</subject><subject>Emergency services</subject><subject>Evaluation</subject><subject>Older people</subject><subject>Tics</subject><issn>0002-0729</issn><issn>1468-2834</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><recordid>eNqFkEFLAzEQRoMotlavHmXBix62TbJpkxxFrAqCF726TLOTEtnN1iQr9N8bafXgxdOQ4c2XmUfIOaNTRnU1gzU6v56BBWBcHZAxEwtVclWJQzKmlPKSSq5H5CTG9_xkc8aPyajiSgsp1Ji8LQdvkus9tAX4pjD92rvkPrFo0LTOY-F80bcNhtxoXXD9EAtohjblYlNugy-ww7BGb7aZ2UBIHfpUfLro0ik5stBGPNvXCXld3r3cPpRPz_ePtzdPpam0TKVSIAxohlKsrLVSCawk2pWuqMwbg8YGbaMY43Mr0Wht6QoolzZPCzBYTcjVLncT-o8BY6o7Fw22LXjMG9dcCKopU7zK6OUf9L0fQr7_m8o_L_Q865uQ6Y4yoY8xoK03wXUQtjWj9bf5eme-3pvPAxf72GHVYfOL_6jOwPUO6IfNf2FfOW-QcA</recordid><startdate>20210108</startdate><enddate>20210108</enddate><creator>Giroux, Marianne</creator><creator>Émond, Marcel</creator><creator>Nadeau, Alexandra</creator><creator>Boucher, Valérie</creator><creator>Carmichael, Pierre-Hugues</creator><creator>Voyer, Philippe</creator><creator>Pelletier, Mathieu</creator><creator>Gouin, Émilie</creator><creator>Daoust, Raoul</creator><creator>Berthelot, Simon</creator><creator>Lamontagne, Marie-Eve</creator><creator>Morin, Michèle</creator><creator>Lemire, Stéphane</creator><creator>Sirois, Marie-Josée</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20210108</creationdate><title>Functional and cognitive decline in older delirious adults after an emergency department visit</title><author>Giroux, Marianne ; Émond, Marcel ; Nadeau, Alexandra ; Boucher, Valérie ; Carmichael, Pierre-Hugues ; Voyer, Philippe ; Pelletier, Mathieu ; Gouin, Émilie ; Daoust, Raoul ; Berthelot, Simon ; Lamontagne, Marie-Eve ; Morin, Michèle ; Lemire, Stéphane ; Sirois, Marie-Josée</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c397t-88a4ca91e74bfff784e37efb9307512a9edefd81125f7ec99f0ba027f3974ace3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Cognitive ability</topic><topic>Cognitive functioning</topic><topic>Cognitive impairment</topic><topic>Confusion</topic><topic>Delirium</topic><topic>Emergency medical care</topic><topic>Emergency services</topic><topic>Evaluation</topic><topic>Older people</topic><topic>Tics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Giroux, Marianne</creatorcontrib><creatorcontrib>Émond, Marcel</creatorcontrib><creatorcontrib>Nadeau, Alexandra</creatorcontrib><creatorcontrib>Boucher, Valérie</creatorcontrib><creatorcontrib>Carmichael, Pierre-Hugues</creatorcontrib><creatorcontrib>Voyer, Philippe</creatorcontrib><creatorcontrib>Pelletier, Mathieu</creatorcontrib><creatorcontrib>Gouin, Émilie</creatorcontrib><creatorcontrib>Daoust, Raoul</creatorcontrib><creatorcontrib>Berthelot, Simon</creatorcontrib><creatorcontrib>Lamontagne, Marie-Eve</creatorcontrib><creatorcontrib>Morin, Michèle</creatorcontrib><creatorcontrib>Lemire, Stéphane</creatorcontrib><creatorcontrib>Sirois, Marie-Josée</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Age and ageing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Giroux, Marianne</au><au>Émond, Marcel</au><au>Nadeau, Alexandra</au><au>Boucher, Valérie</au><au>Carmichael, Pierre-Hugues</au><au>Voyer, Philippe</au><au>Pelletier, Mathieu</au><au>Gouin, Émilie</au><au>Daoust, Raoul</au><au>Berthelot, Simon</au><au>Lamontagne, Marie-Eve</au><au>Morin, Michèle</au><au>Lemire, Stéphane</au><au>Sirois, Marie-Josée</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Functional and cognitive decline in older delirious adults after an emergency department visit</atitle><jtitle>Age and ageing</jtitle><addtitle>Age Ageing</addtitle><date>2021-01-08</date><risdate>2021</risdate><volume>50</volume><issue>1</issue><spage>135</spage><epage>140</epage><pages>135-140</pages><issn>0002-0729</issn><eissn>1468-2834</eissn><abstract>Abstract
Background
the aim of this study was to evaluate the impact of emergency department (ED) stay-associated delirium on older patient’s functional and cognitive status at 60 days post ED visit.
Methods
this study was part of the multi-centre prospective cohort INDEED study. This project took place between March 2015 and July 2016 in five participating EDs across the province of Quebec. Independent non-delirious patients aged ≥65, with an ED stay ≥8 hours, were monitored for delirium until 24 hours post ward admission. A 60-day follow-up phone assessment was conducted. Participants were screened for delirium using the Confusion Assessment Method. Functional and cognitive statuses were assessed at baseline and at the 60-day follow-up using OARS and TICS-m.
Results
a total of 608 patients were recruited, 393 of which completed the 60-day follow-up. The Confusion Assessment Method was positive in 69 patients (11.8%) during ED stay or within the first 24 hours following ward admission. At 60 days, delirium patients experienced an adjusted loss of −2.9/28 [95%CI: −3.9, −2.0] points on the OARS scale compared to non-delirious patients who lost −1.6 [95%CI: −1.9, −1.3] (P = 0.006). A significant adjusted difference in cognitive function was also noted at 60 days, as TICS-m scores in delirious patients decreased by −1.6 [95%CI: −3.5, 0.2] compared to non-delirious patients, who showed a minor improvement of 0.5 [95%CI: −0.1, 1.1] (P = 0.03).
Conclusion
seniors who developed ED stay-associated delirium have lower baseline functional and cognitive status than non-delirious patients, and they will experience a more significant decline at 60 days post ED visit.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>32894748</pmid><doi>10.1093/ageing/afaa128</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Age and ageing, 2021-01, Vol.50 (1), p.135-140 |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Applied Social Sciences Index & Abstracts (ASSIA); Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Cognitive ability Cognitive functioning Cognitive impairment Confusion Delirium Emergency medical care Emergency services Evaluation Older people Tics |
| title | Functional and cognitive decline in older delirious adults after an emergency department visit |
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