Delirium
Articles tagged with Delirium
Restrictive vs liberal physical restraint strategies in critically ill patients
A randomized clinical trial investigated the effectiveness of low-use vs high-use physical restraint strategies in critically ill patients receiving mechanical ventilation in the ICU. The study found no significant reduction in days free of delirium or coma at 14 days, regardless of the restraint strategy used.
Houston Methodist physician granted NIH award to explore how virtual reality therapy may combat ICU delirium
A Houston Methodist physician is exploring how virtual reality can treat delirium in ICU patients by immersing them in digital environments. Her project aims to reduce delirium incidence through cognitive stimulation therapy, building on prior studies that confirmed its safety and feasibility.
Cellular hazmat team cleans up tau. Could it prevent dementia?
Researchers at UC San Francisco have identified CUL5, a protein that tags tau for elimination, as a key player in preventing the formation of toxic tau protein clumps that can lead to dementia. The study found that neurons with more CUL5 are less vulnerable to Alzheimer's disease.
Developing dehydration and other age-related conditions following major surgery linked to dramatically worse outcomes for older adults
A national study found that older adults who develop geriatric syndromes after major surgery face higher risks of poor outcomes, including complications, fewer days spent at home, and increased likelihood of dying within a year. The study emphasizes the need for specialized surgical care approaches to optimize outcomes for older adults.
Disrupted connectivity of the brainstem ascending reticular activating system nuclei-left parahippocampal gyrus could reveal mechanisms of delirium following basal ganglia intracerebral hemorrhage
Delirium in critically ill patients with basal ganglia intracerebral hemorrhage shows disrupted connectivity between the brainstem's ascending reticular activating system nuclei and the left parahippocampal gyrus. This disruption is linked to delirium occurrence and may serve as a biomarker for prediction.
Do some antihistamines increase dementia risk in older hospitalized patients?
A study found that first-generation antihistamines may increase delirium risk in older hospital patients. The analysis of 328,140 patients aged 65+ revealed a 41% increased odds of delirium among those prescribed higher amounts of these medications.
Cognitive outcomes similar after noncardiac surgery whether perioperative hypotension- or hypertension-avoidance strategies employed
A randomized controlled trial found similar neurocognitive outcomes after noncardiac surgery with either a hypotension-avoidance or hypertension-avoidance strategy. The study of 2,603 patients showed no significant difference in postoperative delirium and one-year cognitive decline between the two groups.
AI Model Improves Delirium Prediction, Leading to Better Health Outcomes for Hospitalized Patients
A novel AI model developed by researchers at Mount Sinai improved delirium detection by quadrupling the rate of identification and treatment in hospitalized patients. The model accurately calculates delirium risk in real-time and integrates smoothly into clinical workflows, helping staff catch and treat more patients with delirium.
Preventing cellular senescence to prevent neuroinflammation
Researchers found that surgery induces accumulation of senescent cells in the hippocampal region of aged mice, leading to neuroinflammation. Dosing with a combination of Dasatinib and Quercetin reduced surgery-induced inflammation.
Eye test could predict postoperative delirium in older patients
Researchers found that a thicker preoperative macular layer in the right eye was associated with an increased risk of postoperative delirium. The study suggests that retinal imaging may serve as a non-invasive biomarker to identify individuals at risk, particularly after anesthesia and surgery.
Thickening of the eye’s retina associated with greater risk and severity of postoperative delirium in older patients
A study published in General Psychiatry found that thickening of the macular layer of the retina is associated with a greater risk of postoperative delirium in older patients. Patients with thicker retinas were more likely to develop delirium and experience greater severity, suggesting that macular thickness may serve as a non-invasive...
Study finds persistent delirium in skilled nursing facilities has dropped between 2014 and 2019
A study found that delirium prevalence at SNF admission decreased from 4.3% to 2.5% between 2014 and 2019, with a significant reduction in persistent delirium among female, frail, and dementia subgroups.
More hospital rehabilitation may not mean you’re home sooner
A new study suggests that hospital rehabilitation for older adults might only be the beginning of a longer journey. While therapy is crucial in mitigating functional decline, only a small minority of patients receiving intensive therapy (14+ hours/week) had a greater likelihood of home discharge.
Study uses design features of the ICU to evaluate delirium
A new study found that patients in ICU rooms with windows were more likely to develop delirium than those without windows. Researchers analyzed electronic medical records and observed a 5% increase in delirium cases in windowed rooms compared to non-windowed rooms.
ACS program cuts surgical deaths and improves care for older adults, studies show
The American College of Surgeons Geriatric Surgery Verification program reduces surgical death rates by nearly half and increases the percentage of patients with documented care preferences. Implementing the program also enables hospitals to improve patient-centered care and reduce costs.
In-hospital delirium and disability and cognitive impairment after COVID-19 hospitalization
A cohort study of 311 hospitalized older adults with COVID-19 found that in-hospital delirium is associated with increased functional disability and cognitive impairment after discharge. Postdischarge follow-up should assess for these conditions in survivors experiencing in-hospital delirium.
Delirium in the cardiac patient
Delirium is a disturbance in attention and awareness that develops over a short period, commonly occurring in cardiac patients undergoing surgery. Recognizing delirium early can lead to tailored work-up and intervention, reducing duration and negative consequences.
Delirium a ‘strong risk factor’ for dementia among older people
A large retrospective cohort study found that delirium in hospital patients aged 65+ is associated with a threefold increased risk of dementia. Delirium was linked to a higher risk of death and a tripled risk of dementia diagnosis compared to patients without delirium.
New AEM systematic review examines head imaging abnormalities in patients with acute delirium in the emergency department
A systematic review of geriatric ED patients with delirium reveals that 16% of older adults presenting with altered mental status have acutely abnormal head imaging findings. Focal neurological deficits greatly increase the risk of abnormal head CTs, while anticoagulation is not associated with these abnormalities.
A supervised hospital walking program may reduce nursing facility admissions for older adults
A supervised hospital walking program has been shown to reduce nursing facility admissions for older adults by lowering the proportion of patients discharged to skilled nursing facilities from 13% to 8%. However, low participation rates and limited impact on length of stay or inpatient falls were noted.
Gut bacteria may contribute to delirium in elderly patients after surgery
A study found an association between gut microbiota and postoperative delirium in elderly patients, with higher levels of Parabacteroides distasonis positively associated with delirium. The findings suggest a possible pathogenesis of postoperative delirium and may lead to targeted interventions for better outcomes.
Another pharmacological approach fails to diminish delirium severity or duration
A study of 4,791 patients found that taking ACE inhibitors and angiotensin receptor blockers for at least six months prior to ICU admission did not lower the prevalence of delirium. Chronic high blood pressure is a risk factor for ICU-acquired delirium.
Can alcohol-associated burn injuries impair cognitive function?
Burn-injured patients who use alcohol experience more severe complications, delayed recovery, and increased morbidity and mortality. Researchers found a correlation between inflammation markers and delirium during hospitalization, suggesting impaired cognitive function as a potential issue.
Developing postoperative delirium is associated with a faster rate of cognitive decline
Developing postoperative delirium is associated with a 40% faster rate of cognitive decline compared to those who do not develop delirium. The study, which followed 560 older adults for up to six years, found that delirium influences every time point and is linked to sharper drops in cognition and faster declines over time.
Checklist Prompters Support ICU Rounds
A study published in the American Journal of Critical Care found that a single trained observer serving as a checklist prompter can accurately assess whether multidisciplinary rounds addressed key elements of the ABCDEF bundle. This approach enables customized, shorter checklists to streamline workflows and improve patient care.
Remote protocols broaden the reach of delirium care
A new study modified the Hospital Elder Life Program (HELP) for remote use, enabling hospitals to continue support despite in-person interactions limitations. The adapted protocol achieved full implementation and high adherence, supporting improved delirium prevention and care for older adults.
Regenstrief research scientist receives Beeson Emerging Leaders Career Development Award
Regenstrief Institute Research Scientist Sikandar Khan received the prestigious Paul Beeson Emerging Leaders Career Development Award to study the role of reactive oxygen species in cognitive impairment. The award supports his work on delirium, a common complication in ICU patients with acute respiratory failure, which can lead to post...
Estrogen may offer protection against delirium
Researchers at Cedars-Sinai found that estrogen can prevent symptoms of delirium in mice with urinary tract infections, reducing IL-6 levels in the blood and protecting neurons. The study suggests estrogen may be a tool to mitigate delirium, particularly in older women with UTIs.
Aging | The potential benefit of metformin to reduce delirium risk and mortality: a retrospective cohort study
A retrospective cohort study of 1,404 subjects with type 2 diabetes found that metformin use reduced the risk of delirium by 50% and decreased 3-year mortality rates. The study suggests that metformin may be a potential benefit for patients with diabetes, particularly in reducing age-related disorders such as dementia.
Researchers from the Marcus Institute for Aging Research and University of Michigan receive more than $13 million in funding to study the prevention of delirium in older adults
A new study aims to determine if family caregiver support can reduce risk of delirium and improve outcomes for patients. Researchers will test a program combining Hospital Elder Life Program (HELP) with family involvement.
Patients with Alzheimer’s dementia and related disorders who also have delirium incur greater healthcare costs that increase over time
A recent study by Brigham and Women's Hospital reveals that patients with Alzheimer's dementia and related disorders who also experience delirium incur significantly higher healthcare costs. The average additional cost for one delirium ADRD patient's year of care is $34,828 more than non-delirium ADRD counterparts.
New study reveals possible brain mechanisms behind COVID-19 delirium
Researchers found that blood from COVID-19 patients with delirium causes an increase in cell death and a decrease in new brain cells, indicating a key role for inflammatory proteins. This understanding could help inform treatments to reduce symptoms of confusion and disorientation.
Treble clef treatment: Music to counter delirium in mechanically ventilated older adults in the ICU
A study by Regenstrief Institute and Indiana University School of Medicine found that music can reduce the likelihood of critically ill, mechanically ventilated older adults developing delirium. Music exposure was associated with improved post-ICU brain health and reduced risk of death.
Steroid meds linked to structural and volume changes in brain white and grey matter
A large study found associations between steroid use and structural changes in brain white and grey matter, which may explain neuropsychiatric side effects. Steroid use was associated with reduced white matter structure and altered brain structures involved in cognitive and emotional processing.
Research team awarded more than $10 million to improve cognitive recovery of post-operative delirium survivors
A research team has been awarded $10 million to develop a collaborative care model to prevent Alzheimer's disease and other dementias among delirium survivors. The study aims to improve cognitive recovery and quality of life for patients after emergency surgery.
Alzheimer’s disease biomarkers can predict postoperative delirium
Research at Massachusetts General Hospital has identified plasma biomarkers Tau-PT217 and Tau-PT181 as predictors of postoperative delirium. High preoperative concentrations of these biomarkers are associated with increased risk, suggesting a potential early warning sign for patients.
Older adults with superior memories may have built-in protection against delirium following surgery
A study found that older adults with superior memories, known as 'SuperAgers,' have a greater thickness in the anterior mid-cingulate cortex, potentially making it a biomarker for predicting delirium after surgery. This region of the brain regulates effort and behaviors, and its structure can be improved with training.
Holocaust survivors may have a lower risk of post-operative delirium, Israeli study finds
Researchers found that Holocaust survivors were 40% less likely to develop post-operative delirium than age-matched non-survivors. They also had a higher risk of falls in hospital but no overall difference in other adverse outcomes.
Researchers develop scoring tool to measure severity of delirium
Researchers developed a novel delirium severity score to assess its impact on patient outcomes. The DEL-S score is associated with longer hospital stays, increased costs, and mortality in older patients with delirium.
US falls short in ‘geriatricizing’ emergency departments
The US falls short in 'geriatricizing' emergency departments, with most institutions lacking resources and support to implement the Geriatric Emergency Department (GED) Guidelines. Delirium, falls, and polypharmacy are common issues that require more attention from care teams.
Seeing the same GP improves treatment for people with dementia, study finds
A new study found that people with dementia who see the same GP consistently have lower rates of health complications and fewer emergency hospital admissions. They are also less likely to develop delirium and incontinence, and receive safer prescribing.
China-wide study will boost understanding of fatal surgical complication
A recent China-wide study investigated the effect of general versus regional anesthesia on post-operative delirium in older adults undergoing hip fracture surgery. The results showed no significant difference in delirium incidence between the two groups, contradicting previous assumptions.
Anxiety drugs and antidepressants trigger post-surgery delirium
A new Australian study has found that taking anxiety drugs like nitrazepam and antidepressants before hip or knee surgery can lead to postoperative delirium. The risk is particularly high for older patients, highlighting the need to adjust medication regimens before undergoing elective procedures.
PCORI Board approves $49.5 million to fund new research studies addressing pain relief, smoking cessation, mental health and other conditions
The Patient-Centered Outcomes Research Institute (PCORI) Board approved funding for nine new comparative clinical effectiveness research studies addressing various health conditions. These studies focus on telehealth and mobile health strategies, reducing disparities in maternal health, and improving care for people with intellectual a...
Flexible sigmoidoscopy screening associated with long-term reduction in colorectal cancer incidence and mortality
Flexible sigmoidoscopy screening significantly reduces colorectal cancer incidence and mortality, with a substantial protective effect maintained up to 19 years. The study's findings confirm the safety and effectiveness of flexible sigmoidoscopy as a preventive measure.
Social determinants of health provide better understanding of brain vulnerability to delirium
A Hebrew SeniorLife study provides a novel framework for understanding the social determinants of health that influence the development of delirium in older adults. The framework identifies environmental, historical, and social variables that may protect against or precipitate delirium.
EMS ketamine use on agitated patients on cocaine increases intubation 5.75-fold
A new study published in Prehospital and Disaster Medicine found that prehospital ketamine administration for excited delirium with concomitant cocaine intoxication significantly increases the risk of subsequent emergency department intubation. The study's findings suggest that cocaine may deplete excitatory neurotransmitters, leading ...
Delirium is a common consequence of severe COVID-19, study finds
A study found that 73% of hospitalized COVID-19 patients developed delirium, leading to lasting cognitive impairment and increased need for skilled nursing care. The disease itself, sedatives, and inflammation can contribute to this outcome.
Better healthcare management can reduce the risk of delirium among older adults
A new study finds that delayed hospital floor transfers and ED arrivals on Sundays are associated with a higher short-term risk of delirium in older patients. Delirium is a serious cognitive disorder that can be prevented in up to 40% of cases, and improved processes between the ED and hospital can help reduce its occurrence.
To prevent delirium, increase mobility, connection and sleep
A comprehensive delirium prevention care pathway implemented at UCSF Medical Center reduced hospital stays by 2% and 30-day readmissions by 14%, with cost savings of $1,237 per hospitalization. The interventions also improved patient mobility and social connection, potentially mitigating the risk of accelerated cognitive decline.
Researchers identify predictive factors of delirium in Sub-Saharan Africa
Researchers found that severity of illness, history of stroke, and being divorced or widowed are predictive factors of delirium. Nearly 50% of patients admitted to the hospital had delirium at admission, highlighting the need for earlier identification and management.
Dementia and COVID: What families and physicians should know
A new study published in the Journal of Alzheimer's Disease found that COVID-19 patients with dementia were more likely to experience delirium and confusion compared to those without dementia. While dementia itself was not a primary driver of mortality, other factors such as age and comorbidities played a significant role.
Study shows economic impact of post-op delirium
A recent study published in JAMA Surgery reveals that post-operative delirium has substantial public health implications, resulting in higher healthcare costs for older adults. If delirium were prevented or made less severe, it could reduce healthcare costs by $33 billion per year.
Costs associated with delirium in older adults after elective surgery
A recent study estimates that delirium in older adults one year after major elective surgery results in significant healthcare costs. The study analyzed Medicare claims and clinical data to determine the financial impact of delirium on patients, providing valuable insights for clinicians and policymakers.
Researchers ID blood protein that sheds light on common, post-operative complication
Researchers discovered a single blood protein associated with increased risk of post-operative delirium. The finding paves the way for a non-invasive test to guide prediction, diagnosis and monitoring of delirium.
Researchers find delirium in hospitalized patients linked to mortality, disability
Researchers found that delirium in critically ill patients is associated with higher mortality and disability rates at six months after discharge. The study evaluated 711 patients in Zambia and found that delirium occurred in 48.5% of cases, predicting higher odds of mortality and disability.
Large study finds higher burden of acute brain dysfunction for COVID-19 ICU patients
A large international study found that COVID-19 patients in ICUs were subject to a significantly higher burden of delirium and coma, with 82% comatose and 55% delirious. The study attributes this to outdated sedation practices and reduced family visitation.
Delirium in older patients with COVID-19
A study examined the frequency of delirium in older adults with COVID-19 presenting to emergency departments. The researchers found that a significant proportion of patients developed delirium during their hospital stay.
Ohio State study finds playing brain games before surgery helps improve recovery
Researchers found that exercising your brain with 'neurobics' before surgery can help prevent post-surgery delirium. Patients who played brain games for at least five hours a day saw a significant reduction in delirium rates, with those playing up to 10 hours experiencing a 61% decrease.