Articles tagged with Delirium
Delirium is a common and preventable complication in older surgical patients, with verified geriatric surgery programs screening nearly every patient. Non-accredited hospitals screen only half of their patients for delirium, leading to a stark gap in care.
Postoperative delirium is a strong predictor of long-term cognitive decline in older adults, according to a new study. Researchers found that delirium was associated with faster cognitive decline than mild cognitive impairment, and rehospitalizations did not explain the effect.
Researchers found biomarkers for Alzheimer's disease that correlated with minor cognitive differences in midlife adults. These biomarkers, measuring tau and amyloid plaque, were associated with a greater chance of cognitive decline, particularly in processing speed and executive function.
A new study reviews key components of older adult surgical care, including delirium prevention and screening, fall prevention, and bowel regimens. The seven-component perioperative protocol is associated with improved outcomes, such as reduced complications and shorter hospital stays.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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...
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.
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.
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.
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.
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 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.
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.
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 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.
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.
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.
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 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.
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.
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 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...
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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 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.
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.
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.
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.
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.
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 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.
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.
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 ...
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.
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.
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 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.
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.
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.
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.
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 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.