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Poor functional recovery after delirium is associated with other geriatric syndromes and additional illnesses

Published online by Cambridge University Press:  18 December 2014

Monidipa Dasgupta  and
Chris Brymer
Monidipa Dasgupta*
Affiliation:
Division of Geriatric Medicine, Department of Medicine, Shulich School of Medicine, University of Western Ontario, University Hospital, 339 Windermere Road, London, On, Canada, N6A 5A5 Lawson Health Research Institute, London, Ontario, Canada
Chris Brymer
Affiliation:
Division of Geriatric Medicine, Department of Medicine, Shulich School of Medicine, University of Western Ontario, University Hospital, 339 Windermere Road, London, On, Canada, N6A 5A5
*
Correspondence should be addressed to: Monidipa Dasgupta, Associate Professor, Geriatric medicine-B9-103, University Hospital, 339 Windermere Road, London, ON, CanadaN6A 5A5. Phone: 519-685-8500, ext. 33922#; Fax: 519-663-3472. Email: [email protected].
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Abstract

Background:

Delirious individuals are at increased risk for functional decline, institutionalization and death. Delirium is also associated with other geriatric syndromes, behavioral care issues, and new illnesses. The objectives of this study were to determine how often certain geriatric syndromes, care issues, and additional diagnoses occur in delirious individuals, and to see whether they correlate with worse functional recovery.

Methods:

Consecutive delirious older medical in-patients (n = 343) were followed for the occurrence of geriatric syndromes (falls, pressure ulcers, poor oral intake, and aspiration), care issues (refusing treatments or care, need for sitters, security services, physical restraints, and new neuroleptic medications) and additional diagnoses occurring after the third day of admission. Poor functional recovery was defined by any one of death, permanent institutionalization or increased dependence for activities of daily living (ADLs) at discharge or three months after discharge from hospital, elicited through chart review or a follow-up telephone interview.

Results:

Poor functional recovery was seen in 237 (69%) delirious patients. Geriatric syndromes and additional illnesses were common and associated with poor functional recovery (falls in 21%, adjusted OR 2.27; possible aspiration in 26%, adjusted OR 3.06; poor oral intake in 49%, adjusted OR = 2.31; additional illnesses in 38%, adjusted OR 3.54). Care issues were also common (range 9%–54%) but not associated with poor recovery.

Conclusions:

Geriatric syndromes, behavioral care issues and additional illnesses are common in delirium. Future studies should assess whether monitoring for and intervening against geriatric syndromes and additional illnesses may improve functional outcomes after delirium.

Keywords

deliriumactivities of daily livingaged careadverse events
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 5 , May 2015 , pp. 793 - 802
Copyright
Copyright © International Psychogeriatric Association 2014 

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