| Title: |
Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study |
| Authors: |
Faheem, W; Lin, J; Nandra, T; Richardson, S; Saliu, D; Wilson, D; Jackson, TA; Magill, L; McCluskey, L; Perry, R; Welch, C; Copeland, C; Cunningham, EL; Davis, D; Treml, J; Pinkney, T; Quinn, T; Nightingale, P; Jelley, B; Gaunt, V; Lochlainn, MN; Giridharan, K; Alsahab, M; Makin, S; Torsney, K; Masoli, J; Ronan, L; Burton, JK; Todd, O; Taylor, J; Willott, R; Cox, N; Healy, R; Haddad, N; Ramakrishna, S; Subhan, Z; Mazzoleni, A; Nynaes, O; Crofts, J; McNicholas, E; Robinson, HJ; Thyn, T; Baillie, J; McKeown, W; Rice, C; Sloan, GW; Williamson, K; Hayat, Y; Lim, VH; Millichamp, K; Bazaraa, A; Chilton, A; Harbinson, A; Headlam, J; Hunter, E; Hussain, Z; Mahmood, AW; Ng, L; Sundara, S; Tan, F; Wheeler, A; Wright, S; Baldwin, JBG; O'shea, K; Hodhody, G; Mayor, K; Patel, R; Bhakta, S; Goujon, M; Jakupaj, A; Dove, J; Kearney, M; McCormack, V; Moore, K; Pope, L; Shah, H-A; Shaw, ME; Smith, GM; Love, R; Mukundan, M; Shahid, M; Alareed, A; Beharry, K; Bhat, G; Bremakumar, S; Caines, L; Darko, S; Rai, N; De Mucha, PV; Adams, P; McDonald, H; Mills, S; Parry, F; Rickard, F; Winearls, S; Farah, R; Grange, R; Herbert, F; Lonsdale-Eccles, E; Ul Ain, Q; Watson, H; Bultynck, C; Cavaliere, C; Doherty, C; Evans, S; Furmedge, D; MacCuish, AH; Hindley, E; Meyer, C; Mullarkey, E; Pullen, R; Ryan, A; Sarma, D; Seymour, E; Stambollouian, K; Thayabaran, D; Wu, C; Peck, G; Raza, M; Sahnan, K; Dhillon, A; Abiola, OO; Bryant, C; Bygate, R; Frewen, J; Greaves, I; Morrow, O; Tetlow, S; Tinson, G; Yunus, A; Bedi, S; Evans, O; Giet, L; Behbahani, A; Bhattacharya, S; Hunt, C; Mishra, R; Connor, L; Poynton, J; Deacon, E; Durcan, R; Fisken, E; Hall, SA; Noble, J; Prendergast, EL; Macharouthu, A; Macrae, V; Murphy-Ackroyd, E; Rose, EC; Watt, N; Blair, M; Mackenzie, ER; McCormack, R; Irwin, SJ; Einarsson, A; Khor, M; Alhadadi, B; Cameron, E; Campbell, A; Capek, E; Christie, L; Connell, L; Cook, A; Deosaran, J; Elliott, M; Evans, E; Fancourt, S; Henderson, S; Hussain, A; Jones, K; Kelly, D; McErlean, CM; Miller, H; Naeem, F; Ostrowski, C; Parkinson, M; Sami, F; Shepherd, A; Whyte, L; Wright, E; Ferguson, EEC; Gallagher, M; McCluskey, HJ; Beveridge, L; Clements, HA; Hart, J; Henderson, N; Lim, SK; Lucocq, JE; McCulloch, A; Murray, AA; Ngan, EEY; Traill, PK; Walter, A; Wilson, MSJ; Wrathall, A; Yap, ZJ; Anderson, C; Abu-Arafeh, H; Gluck, I; Mitchell, O; Robson, R; Sampson, EL; Annamalai, A; Bhatti, J; Briggs, L; Fraser, D; Gui, J; Leah, E; Matthews, NR; Mithrakumar, P; Moad, M; Sen, M; Straughan, J; Taranu, R; Usmani, K; Aamir, A; Achara, A; Akintade, O; Ellis, EJ; Gurung, S; Iwu, C; Khalid, AB; Koshedo, S; Nagumantry, S; Nashed, N; Nwabufor, P; Obi, IT; Visvaratnam, P; Wu, E; Bertagne, M; Jackson, P; Allen, J; Brown, H; Champion, J; Christodoulides, N; Handley, O; Macdonald, FE; Beeley, LJ; Clayton, V; Kay, A; Marshall, J; Morgan, H; Naish, G; Cleaver, SL; Evans, J; Morrow, A; Amarnani, R; Cheah, KL; Cushen, C; Enfield-Bance, A; Glasser, M; Govindji, S; Mani, S; Gregory, J; Jatti, P; Khan, A; Lee, H; Millner, H; Naqvi, H; Williamson, E; Harkin, T; Khizar, B; Lewis, A; Pendleton, H; Rutter, S; Ahmed, R; Coffey, F; Hackett, B; Holmes, EAM; Mustafa, Z; Bowman, MA; Irvine, J; Patterson, K; Horner, S; Wong, TW; Cairns, C; Foster, K; Hornsby, A; Horton, R; Jones, L; King, R; Lyon, E; Tencheva, A; Wilson, F; Young, LJ; Dama, S; Giblin, E; Kunaselan, L; Lowes, O; Menezes, R; Taylor, A; Timperley, A; Batho, R; Bell, C; Carter, S; Croft, P; Griffiths, E; Hall, G; Hunt, W; Jacques, H; Leishman, F; Murthy, S; Quinn, S; Reidm, J; Walker, A; Matthews, SA; Ferreira, AS; Ashton, C; Byravan, S; Cummings, L; Faruq, S; Jagdeo, S; Thomas, P; Broadhurst, K; Wilson, JB; Bowden, H; Hoffman, K; Jones, HT; Katz-Summercorn, C; Khambay, E; Porter, L; Speed, J; Austin, K; Bahsoon, F; Laud, R; Ali, J; Fergusson, N; Wilkes, C; Babb, L; Gaywood, J; Green, J; Kantczak, A; Madden, KF; Porter-Bent, S; San, MSS; Babar, L; Chamberlain, H; Cricklow, T; Giles, A; Gupta, A; Hughes, C; Lee, T; Cheema, A; Matheswaran, Y; Nneamaka, A; Ross, A; Vedutla, T; Allain, TJ; Bowen, E; Dovey, J; Gaskell, N; Scott, D; Stratton, E; Thake, M; Bullock, S; McKay, S; Radoja, S; Abdelbadiee, S; Cohen, S; Giddings, J; Miller, CJ; Mumtaz, E; Patel, MD; Prasad, V; Satharasinghe, L; Studley, M; Browne, M; Durrant, SK; Jay, E; McQuillan, A; Offer, M; Varghese, J; Baron, A; Chourot, C; Kirrane, K; Rayner, H; Tantam, K; Tumi, E; Venkat, S; Aggarwal, N; Astaire, E; Basker, K; Berwick, L; Bilton, E; Chamboult, A-L; Chapman, G; Chevolleau, J; Fenneley, G; House, S; Ingamells, N; Jewell, E; Kalyaani, V; Kiani, M; Konda, N; Kumar, A; Lai, J; Large, J; Livesey, J; Majid, Z; McCready, J; Moorey, H; Morgan, B; Morrison, K; Mosley, A; Pailing, A; Pettler, S; Rashid, S; Rimmer, L; Scarlett, D; Sehmbi, G; Smith, A; Smith, N; Sprosen, C; Taylor, E; Tse, C; Turton, S; Vardon, H; Virk, J; Warwicker, S; Woodman, H; Woodward, BL; Wynne, L; Yule, O; Ahmad, A; Appiah-Odame, P; Barlow, C; Kuek, DKC; Nicholls, I; Norman, E; Pyc, W; Vasudev, A; Adams, LAT; Box, E; Chai, CS; Wilson, DS; Drozdowska, B; Elliott, E; Stirling, A; Taylor-Rowan, M; Webb, H; Wong, L; Abras, A; Adam, M; Amin, Z; Cooper, O; Davies, R; Ikhwan, WIC; Layton, GR; Mohammedseid-Nurhussien, A; Shakeel, S; Waraich, H; Ahmed, J; Ball, K; Debrah, K; Page, V; Bei, ZX; McCauley, H; McShane, D; Cooper, F; Grundmann, N; Haley, M; Le Poideven, A; McClelland, SB; Moore, E; Pang, N; Currie, H; Davies-Morris, J; Edwards, S; Janagal, S; Jenkin, R; Jones, P; Kumbun, G; Parry, S; Tyagi, B; Valentine, J; Abdullah, S; Abu, E; Ahmad, S; Ahmed, B; Ahmed, H; Andrusca, A; Ansell, M; Arkle, T; Bargaoanu, I; Chuter, C; Houldershaw, K; Ibanichuka, J; Iqbal, S; Kabia, A; Kadir, I; Krishan, A; McClean, A; McGonigal, G; Mishra, P; Ofoche, G; Reay, A; Stapley, SM; Swietoslawski, A; Syed, N; Velusamy, K; Wahballa, A; Wilcockson, J |
| Source: |
332 ; 325 |
| Publisher Information: |
Springer |
| Publication Year: |
2022 |
| Collection: |
Imperial College London: Spiral |
| Description: |
Purpose Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
European Geriatric Medicine; http://hdl.handle.net/10044/1/108133 |
| DOI: |
10.1007/s41999-022-00737-y |
| Availability: |
http://hdl.handle.net/10044/1/108133; https://doi.org/10.1007/s41999-022-00737-y |
| Rights: |
© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. ; https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.F0AA086A |
| Database: |
BASE |