A Predictive Model of the Prevalence of Delirium in Elderly Subjects Admitted to Nursing Homes

Pérez‐Ros, Pilar; Martínez-Arnau, Francisco Miguel; Baixauli-Alacreu, Susana; García-Gollarte, José Fermín; Tarazona-Santabalbina, Francisco José

doi:10.2174/1871530317666171120152048

Cited by 4 publications

(10 citation statements)

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“…Figure 1 illustrates the study selection process, with 29 studies 20 , 21 , 22 , 23 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 being retained for a meta‐analysis of the associations between delirium and UTI, comprising 16,618 participants, with 26 studies 20 , 21 , 23 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , ...…”

Section: Resultsmentioning

confidence: 99%

“… Forest plot of the main meta‐analysis of 29 studies 20 , 21 , 22 , 23 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 expressing associations between delirium and UTI in older adults. 95% CI, 95% confidence interval …”

Section: Resultsmentioning

confidence: 99%

“…After removing the study with the highest weight 34 as well as after removing one clear outlier with the highest effect size, 55 results remained significant. Subgroup meta‐analyses of studies (1) in which participants with delirium were compared with non‐delirium controls, 20 , 21 , 23 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 (2) in which participants with UTI were compared with non‐UTI controls, 22 , 39 , 56 (3) with a diagnosis of delirium based on DSM or ICD criteria, 23 , 32 , 36 , 37 , 38 , 39 , 40 , 42 , 45 , 46 , 49 , 50 , 53 , 54 , 55 (4) with a diagnosis of UTI based on microbiological urine tests, 22 , 56 (5) conducted in the clinical setting, 21 , 22 ,…”

Section: Resultsmentioning

confidence: 99%

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Associations of delirium with urinary tract infections and asymptomatic bacteriuria in adults aged 65 and older: A systematic review and meta‐analysis

Krinitski

Kasina

Klöppel

et al. 2021

J American Geriatrics Society

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Objective: To determine the associations of delirium with urinary tract infection (UTI) and asymptomatic bacteriuria (AB) in individuals aged 65 and older.Methods: The protocol for this systematic review and meta-analysis was published on PROSPERO (CRD42020164341). Electronic databases were searched for relevant studies, professional associations and experts in the field were additionally contacted. Studies with control groups reporting associations between delirium and UTI as well as delirium and AB in older adults were included. The random effects model meta-analysis was conducted using odds ratios (ORs) with 95% confidence intervals (CIs) as effect size measures. The Newcastle-Ottawa scale was used to rate the studies' quality. Heterogeneity was assessed using the Q and I 2 tests. The effects of potential moderators were investigated by both subgroup and meta-regression analyses. The risk of publication bias was evaluated using the funnel plot and Egger's test.Results: Twenty nine relevant studies (16,618 participants) examining the association between delirium and UTI in older adults were identified. The association between delirium and UTI was found to be significant (OR 2.67; 95% CI 2.12-3.36; p < 0.001) and persisted regardless of potential confounders. The association between delirium and AB in older adults in the only eligible study found (192 participants) was insignificant (OR 1.62; 95% CI 0.57-4.65; p = 0.37). All included studies were of moderate quality. Conclusion:The results of this study support the association between delirium and UTI in older adults. Insufficient evidence was found to conclude on an association between delirium and AB in this age group. These findings are limited due to the moderate quality of the included studies and a lack of available research on the association between delirium and AB. Future studies should use the highest quality approaches for defining both delirium and UTI and consider AB in their investigations.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Associations of delirium with urinary tract infections and asymptomatic bacteriuria in adults aged 65 and older: A systematic review and meta‐analysis

Krinitski

Kasina

Klöppel

et al. 2021

J American Geriatrics Society

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“…From our review, we identified 28 [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ] articles with relevant data regarding the prevalence of delirium, and eight articles [ 11 , 26 , 39 , 40 , 41 , 42 , 43 , 44 ] described the incidence of delirium. Total population mean age ranged from 76.2 years to 88.5 years, and 46.8% to 90.8% of the participants in the studies were female.…”

Section: Review Resultsmentioning

confidence: 99%

“…Infections were characterized by higher odds of delirium onset [ 28 ]. Furthermore, urinary and respiratory infections were mentioned as important precipitating risk factors [ 25 , 39 ].…”

Section: Review Resultsmentioning

confidence: 99%

Delirium in Nursing Home Residents: A Narrative Review

Komici

Guerra

Addona³

et al. 2022

Healthcare

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Delirium is an important component of the geriatric syndromes and has been recognized to negatively influence the prognosis of older people in hospital and in a post-acute setting. About 2–5% of older people world-wide live in nursing homes and are characterized by functional impairment, cognitive decline, dementia, comorbidities, and polypharmacotherapy, all factors which influence the development of delirium. However, in this setting, delirium remains often understudied. Therefore, in this narrative review, we aimed to describe the latest evidence regarding delirium screening tools, epidemiology characteristics, outcomes, risk factors, and preventions strategies in nursing homes.

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Delirium Predisposing and Triggering Factors in Nursing Home Residents: A Cohort Trial-Nested Case-Control Study

Pérez‐Ros

Martínez-Arnau

Baixauli-Alacreu

et al. 2019

JAD

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Background: Delirium is a common geriatric syndrome, with a prevalence of between 15-70% among older long-term care residents. It is associated with adverse outcomes, and its onset may prove imperceptible to health professionals. Few studies in institutionalized older people have analyzed the predictors of delirium. Objective: The aim of the present study was to identify delirium predisposing and triggering factors, and develop a predictive model. Methods: A cohort trial-nested case-control study covering a period of 12 consecutive months (April 2015 -March 2016) was carried out. Predisposing and triggering episodes of delirium were recorded. Results: A total of 443 older persons were recruited, with a mean age of 85.73 (6.72) years and female predominance (78.3%; n = 374). The incidence of older people with delirium was 18.7% (n = 83). Dementia was the predisposing factor with the highest predictive capacity (OR = 2.74 [1.49-5.04]). In the presence of dementia, falls (OR = 2.45 [1.49-3.69]), neuroleptics ) and anticholinergic drug use ) were identified as triggering factors. The area under the curve (AUC) was 0.72 (95%CI: 0.66-0.78). Conclusions: Our findings suggest that interventions targeted to potentially preventable triggering factors could avoid the onset of delirium in older people with dementia. Knowledge of the predictive factors of delirium facilitates the screening of older people at increased risk, thereby allowing mental health service providers to prevent and identify the onset of a delirium episode. The decrease in delirium predictive factors should lead to a direct reduction in the occurrence of delirium and its consequences.

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A Predictive Model of the Prevalence of Delirium in Elderly Subjects Admitted to Nursing Homes

Abstract: The prevalence of delirium among elderly subjects admitted to nursing homes was 60.7%. Infections (with the exception of urinary tract infections), dementia, anticholinergic drug use, depression and urinary incontinence were predictive of the presence of delirium.

Cited by 4 publications

References 0 publications

Associations of delirium with urinary tract infections and asymptomatic bacteriuria in adults aged 65 and older: A systematic review and meta‐analysis

Associations of delirium with urinary tract infections and asymptomatic bacteriuria in adults aged 65 and older: A systematic review and meta‐analysis

Delirium in Nursing Home Residents: A Narrative Review

Delirium Predisposing and Triggering Factors in Nursing Home Residents: A Cohort Trial-Nested Case-Control Study

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