Functional and cognitive decline in older delirious adults after an emergency department visit.
| Title: | Functional and cognitive decline in older delirious adults after an emergency department visit. |
|---|---|
| Authors: | Giroux M; Centre de recherche du CHU de Québec-Université Laval, Québec, Canada.; Université Laval, Québec, Canada.; Centre d'excellence sur le vieillissement de Québec, Québec, Canada.; Émond M; Centre de recherche du CHU de Québec-Université Laval, Québec, Canada.; Université Laval, Québec, Canada.; Centre d'excellence sur le vieillissement de Québec, Québec, Canada.; Département de médecine d'urgence, CHU de Québec-Université Laval, Québec, Canada.; Centre de recherche sur les soins et les services de première ligne de l'Université Laval, Québec, Canada.; Nadeau A; Centre de recherche du CHU de Québec-Université Laval, Québec, Canada.; Université Laval, Québec, Canada.; Centre d'excellence sur le vieillissement de Québec, Québec, Canada.; Boucher V; Centre de recherche du CHU de Québec-Université Laval, Québec, Canada.; Université Laval, Québec, Canada.; Centre d'excellence sur le vieillissement de Québec, Québec, Canada.; Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Québec, Canada.; Carmichael PH; Centre d'excellence sur le vieillissement de Québec, Québec, Canada.; Voyer P; Centre de recherche du CHU de Québec-Université Laval, Québec, Canada.; Université Laval, Québec, Canada.; Centre d'excellence sur le vieillissement de Québec, Québec, Canada.; Pelletier M; Université Laval, Québec, Canada.; Centre Intégré de Santé et de Services Sociaux de Lanaudière, Joliette, Canada.; Gouin É; Centre Hospitalier Régional de Trois-Rivières, Trois-Rivières, Canada.; Daoust R; Centre de recherche de l'Hôpital du Sacré-Cœur de Montréal, Montréal, Canada.; Université de Montréal, Montréal, Canada.; Berthelot S; Centre de recherche du CHU de Québec-Université Laval, Québec, Canada.; Université Laval, Québec, Canada.; Département de médecine d'urgence, CHU de Québec-Université Laval, Québec, Canada.; Lamontagne ME; Université Laval, Québec, Canada.; Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Québec, Canada.; Morin M; Centre de recherche du CHU de Québec-Université Laval, Québec, Canada.; Université Laval, Québec, Canada.; Centre d'excellence sur le vieillissement de Québec, Québec, Canada.; Centre de recherche sur les soins et les services de première ligne de l'Université Laval, Québec, Canada.; Lemire S; Centre de recherche du CHU de Québec-Université Laval, Québec, Canada.; Université Laval, Québec, Canada.; Centre d'excellence sur le vieillissement de Québec, Québec, Canada.; Sirois MJ; Centre de recherche du CHU de Québec-Université Laval, Québec, Canada.; Université Laval, Québec, Canada.; Centre d'excellence sur le vieillissement de Québec, Québec, Canada.; Centre de recherche sur les soins et les services de première ligne de l'Université Laval, Québec, Canada. |
| Source: | Age and ageing [Age Ageing] 2021 Jan 08; Vol. 50 (1), pp. 135-140. |
| Publication Type: | Journal Article; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Oxford University Press Country of Publication: England NLM ID: 0375655 Publication Model: Print Cited Medium: Internet ISSN: 1468-2834 (Electronic) Linking ISSN: 00020729 NLM ISO Abbreviation: Age Ageing Subsets: MEDLINE |
| Imprint Name(s): | Publication: Oxford : Oxford University Press; Original Publication: London, Baillière, Tindall. |
| MeSH Terms: | Cognitive Dysfunction*/diagnosis ; Cognitive Dysfunction*/epidemiology ; Delirium*/diagnosis ; Delirium*/epidemiology; Aged ; Emergency Service, Hospital ; Humans ; Prospective Studies ; Quebec |
| Abstract: | Background: the aim of this study was to evaluate the impact of emergency department (ED) stay-associated delirium on older patient's functional and cognitive status at 60 days post ED visit.; Methods: this study was part of the multi-centre prospective cohort INDEED study. This project took place between March 2015 and July 2016 in five participating EDs across the province of Quebec. Independent non-delirious patients aged ≥65, with an ED stay ≥8 hours, were monitored for delirium until 24 hours post ward admission. A 60-day follow-up phone assessment was conducted. Participants were screened for delirium using the Confusion Assessment Method. Functional and cognitive statuses were assessed at baseline and at the 60-day follow-up using OARS and TICS-m.; Results: a total of 608 patients were recruited, 393 of which completed the 60-day follow-up. The Confusion Assessment Method was positive in 69 patients (11.8%) during ED stay or within the first 24 hours following ward admission. At 60 days, delirium patients experienced an adjusted loss of -2.9/28 [95%CI: -3.9, -2.0] points on the OARS scale compared to non-delirious patients who lost -1.6 [95%CI: -1.9, -1.3] (P = 0.006). A significant adjusted difference in cognitive function was also noted at 60 days, as TICS-m scores in delirious patients decreased by -1.6 [95%CI: -3.5, 0.2] compared to non-delirious patients, who showed a minor improvement of 0.5 [95%CI: -0.1, 1.1] (P = 0.03).; Conclusion: seniors who developed ED stay-associated delirium have lower baseline functional and cognitive status than non-delirious patients, and they will experience a more significant decline at 60 days post ED visit.; (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.) |
| Contributed Indexing: | Keywords: cognitive decline; delirium; emergency department; functional decline; older people; seniors |
| Entry Date(s): | Date Created: 20200907 Date Completed: 20210728 Latest Revision: 20210728 |
| Update Code: | 20260130 |
| DOI: | 10.1093/ageing/afaa128 |
| PMID: | 32894748 |
| Database: | MEDLINE |
Journal Article; Research Support, Non-U.S. Gov't