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Delirium in an acute geriatric unit: clinical aspects.
Arch Gerontol Geriatr 1999 Jan-Feb; 28(1):37-44AG

Abstract

Delirium is a common event in geriatric hospitalized patients. A prospective study was performed in order to characterize predictors, features and outcome in an acute geriatric care unit in a general hospital in Israel. The tools used to detect delirium were the Confusion Assessment Method (CAM) and the Delirium Rating Scale (DRS), supported by clinical observation by an experienced geriatrician. Results showed an occurrence of 18%; risk factors were polypharmacy and poor nutritional status. Age, education, ethnic origin, pre-morbid cognition and ADL status did not show any statistical correlation with the occurrence of delirium. Delirious patients experienced longer hospital stays, more complications, high mortality rate, cognitive and functional decline. It is very difficult to prove the correlation between reduction of brain reserve and appearance of delirium, but as we have observed in other systems (cardiovascular, renal, etc.), it seems reasonable to presume that the same mechanism is involved in cognitive function. Our conclusions are that the diagnosis of delirium may be misleading by a psychiatric overwhelming presentation, and should be considered not as a transient event, but as a marker for cognitive and functional decline in the future, and therefore these patients should be looked after once discharged.

Authors+Show Affiliations

The Geriatric Department, Sapir Medical Center, Meir Hospital, Kfar-Saba 44281, Israel.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18656102

Citation

Feldman, J, et al. "Delirium in an Acute Geriatric Unit: Clinical Aspects." Archives of Gerontology and Geriatrics, vol. 28, no. 1, 1999, pp. 37-44.
Feldman J, Yaretzky A, Kaizimov N, et al. Delirium in an acute geriatric unit: clinical aspects. Arch Gerontol Geriatr. 1999;28(1):37-44.
Feldman, J., Yaretzky, A., Kaizimov, N., Alterman, P., & Vigder, C. (1999). Delirium in an acute geriatric unit: clinical aspects. Archives of Gerontology and Geriatrics, 28(1), pp. 37-44.
Feldman J, et al. Delirium in an Acute Geriatric Unit: Clinical Aspects. Arch Gerontol Geriatr. 1999;28(1):37-44. PubMed PMID: 18656102.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Delirium in an acute geriatric unit: clinical aspects. AU - Feldman,J, AU - Yaretzky,A, AU - Kaizimov,N, AU - Alterman,P, AU - Vigder,C, PY - 1998/06/08/received PY - 1998/08/13/revised PY - 1998/08/23/accepted PY - 1998/06/08/received PY - 1998/08/13/revised PY - 1998/08/23/accepted PY - 2008/7/29/pubmed PY - 2008/7/29/medline PY - 2008/7/29/entrez SP - 37 EP - 44 JF - Archives of gerontology and geriatrics JO - Arch Gerontol Geriatr VL - 28 IS - 1 N2 - Delirium is a common event in geriatric hospitalized patients. A prospective study was performed in order to characterize predictors, features and outcome in an acute geriatric care unit in a general hospital in Israel. The tools used to detect delirium were the Confusion Assessment Method (CAM) and the Delirium Rating Scale (DRS), supported by clinical observation by an experienced geriatrician. Results showed an occurrence of 18%; risk factors were polypharmacy and poor nutritional status. Age, education, ethnic origin, pre-morbid cognition and ADL status did not show any statistical correlation with the occurrence of delirium. Delirious patients experienced longer hospital stays, more complications, high mortality rate, cognitive and functional decline. It is very difficult to prove the correlation between reduction of brain reserve and appearance of delirium, but as we have observed in other systems (cardiovascular, renal, etc.), it seems reasonable to presume that the same mechanism is involved in cognitive function. Our conclusions are that the diagnosis of delirium may be misleading by a psychiatric overwhelming presentation, and should be considered not as a transient event, but as a marker for cognitive and functional decline in the future, and therefore these patients should be looked after once discharged. SN - 0167-4943 UR - https://www.unboundmedicine.com/medline/citation/18656102/Delirium_in_an_acute_geriatric_unit:_clinical_aspects_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-4943(98)00124-1 DB - PRIME DP - Unbound Medicine ER -