A Point Prevalence Study of Delirium in Italian Nursing Homes

Valeria Morichi, Massimiliano Fedecostante, Alessandro Morandi, Simona Gabriella Di Santo, Andrea Mazzone, Enrico Mossello, Mario Bo, Angelo Bianchetti, Renzo Rozzini, Ermellina Zanetti, Massimo Musicco, Alberto Ferrari, Nicola Ferrara, Marco Trabucchi, Antonio Cherubini, Giuseppe Bellelli

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Delirium is a common geriatric syndrome. Few studies have been conducted in nursing home (NH) residents. The aim of this project was to perform a point prevalence study of delirium in Italian NHs. Methods: Data collected in 71 NHs are presented. Inclusion criteria were age ≥65 years and native Italian speaker. Exclusion criteria were coma, aphasia, and end-of-life status. Sociodemographic and medical data were recorded. Delirium was assessed using the Assessment Test for Delirium and Cognitive Impairment (4-AT). Patients with a 4-AT score ≥4 were considered to have delirium. Motor subtype was evaluated using the Delirium Motor Subtype Scale (DMSS). Results: A total of 1,454 patients were evaluated (mean age 84.4 ± 7.4 years, 70.2% female), of whom 535 (36.8%) had delirium. In multivariate logistic regression analysis, variables significantly associated with delirium were education (OR 0.94, 95% CI 0.91-0.97), dementia (OR 3.12, 95% CI 2.38-4.09), functional dependence (OR 6.13, 95% CI 3.08-12.19 for ADL score 0; OR 1.99, 95% CI 1.03-3.84 for ADL score 1-5), malnutrition (OR 4.87, 95% CI 2.68-8.84), antipsychotics (OR 2.40, 95% CI 1.81-3.18), and physical restraints (OR 2.48, 95% CI 1.71-3.59). Conclusion: Delirium is common in older NH residents. Simple assessment tools might facilitate its recognition in this vulnerable population.

Original languageEnglish
Pages (from-to)27-41
Number of pages15
JournalDementia and Geriatric Cognitive Disorders
DOIs
Publication statusAccepted/In press - Jan 1 2018

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Delirium
Nursing Homes
Cross-Sectional Studies
Activities of Daily Living
Physical Restraint
Aphasia
Vulnerable Populations
Coma
Malnutrition
Geriatrics
Antipsychotic Agents
Dementia
Logistic Models
Regression Analysis
Education

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Cognitive Neuroscience
  • Psychiatry and Mental health

Cite this

A Point Prevalence Study of Delirium in Italian Nursing Homes. / Morichi, Valeria; Fedecostante, Massimiliano; Morandi, Alessandro; Di Santo, Simona Gabriella; Mazzone, Andrea; Mossello, Enrico; Bo, Mario; Bianchetti, Angelo; Rozzini, Renzo; Zanetti, Ermellina; Musicco, Massimo; Ferrari, Alberto; Ferrara, Nicola; Trabucchi, Marco; Cherubini, Antonio; Bellelli, Giuseppe.

In: Dementia and Geriatric Cognitive Disorders, 01.01.2018, p. 27-41.

Research output: Contribution to journalArticle

Morichi, V, Fedecostante, M, Morandi, A, Di Santo, SG, Mazzone, A, Mossello, E, Bo, M, Bianchetti, A, Rozzini, R, Zanetti, E, Musicco, M, Ferrari, A, Ferrara, N, Trabucchi, M, Cherubini, A & Bellelli, G 2018, 'A Point Prevalence Study of Delirium in Italian Nursing Homes', Dementia and Geriatric Cognitive Disorders, pp. 27-41. https://doi.org/10.1159/000490722
Morichi, Valeria ; Fedecostante, Massimiliano ; Morandi, Alessandro ; Di Santo, Simona Gabriella ; Mazzone, Andrea ; Mossello, Enrico ; Bo, Mario ; Bianchetti, Angelo ; Rozzini, Renzo ; Zanetti, Ermellina ; Musicco, Massimo ; Ferrari, Alberto ; Ferrara, Nicola ; Trabucchi, Marco ; Cherubini, Antonio ; Bellelli, Giuseppe. / A Point Prevalence Study of Delirium in Italian Nursing Homes. In: Dementia and Geriatric Cognitive Disorders. 2018 ; pp. 27-41.
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abstract = "Background: Delirium is a common geriatric syndrome. Few studies have been conducted in nursing home (NH) residents. The aim of this project was to perform a point prevalence study of delirium in Italian NHs. Methods: Data collected in 71 NHs are presented. Inclusion criteria were age ≥65 years and native Italian speaker. Exclusion criteria were coma, aphasia, and end-of-life status. Sociodemographic and medical data were recorded. Delirium was assessed using the Assessment Test for Delirium and Cognitive Impairment (4-AT). Patients with a 4-AT score ≥4 were considered to have delirium. Motor subtype was evaluated using the Delirium Motor Subtype Scale (DMSS). Results: A total of 1,454 patients were evaluated (mean age 84.4 ± 7.4 years, 70.2{\%} female), of whom 535 (36.8{\%}) had delirium. In multivariate logistic regression analysis, variables significantly associated with delirium were education (OR 0.94, 95{\%} CI 0.91-0.97), dementia (OR 3.12, 95{\%} CI 2.38-4.09), functional dependence (OR 6.13, 95{\%} CI 3.08-12.19 for ADL score 0; OR 1.99, 95{\%} CI 1.03-3.84 for ADL score 1-5), malnutrition (OR 4.87, 95{\%} CI 2.68-8.84), antipsychotics (OR 2.40, 95{\%} CI 1.81-3.18), and physical restraints (OR 2.48, 95{\%} CI 1.71-3.59). Conclusion: Delirium is common in older NH residents. Simple assessment tools might facilitate its recognition in this vulnerable population.",
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T1 - A Point Prevalence Study of Delirium in Italian Nursing Homes

AU - Morichi, Valeria

AU - Fedecostante, Massimiliano

AU - Morandi, Alessandro

AU - Di Santo, Simona Gabriella

AU - Mazzone, Andrea

AU - Mossello, Enrico

AU - Bo, Mario

AU - Bianchetti, Angelo

AU - Rozzini, Renzo

AU - Zanetti, Ermellina

AU - Musicco, Massimo

AU - Ferrari, Alberto

AU - Ferrara, Nicola

AU - Trabucchi, Marco

AU - Cherubini, Antonio

AU - Bellelli, Giuseppe

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Delirium is a common geriatric syndrome. Few studies have been conducted in nursing home (NH) residents. The aim of this project was to perform a point prevalence study of delirium in Italian NHs. Methods: Data collected in 71 NHs are presented. Inclusion criteria were age ≥65 years and native Italian speaker. Exclusion criteria were coma, aphasia, and end-of-life status. Sociodemographic and medical data were recorded. Delirium was assessed using the Assessment Test for Delirium and Cognitive Impairment (4-AT). Patients with a 4-AT score ≥4 were considered to have delirium. Motor subtype was evaluated using the Delirium Motor Subtype Scale (DMSS). Results: A total of 1,454 patients were evaluated (mean age 84.4 ± 7.4 years, 70.2% female), of whom 535 (36.8%) had delirium. In multivariate logistic regression analysis, variables significantly associated with delirium were education (OR 0.94, 95% CI 0.91-0.97), dementia (OR 3.12, 95% CI 2.38-4.09), functional dependence (OR 6.13, 95% CI 3.08-12.19 for ADL score 0; OR 1.99, 95% CI 1.03-3.84 for ADL score 1-5), malnutrition (OR 4.87, 95% CI 2.68-8.84), antipsychotics (OR 2.40, 95% CI 1.81-3.18), and physical restraints (OR 2.48, 95% CI 1.71-3.59). Conclusion: Delirium is common in older NH residents. Simple assessment tools might facilitate its recognition in this vulnerable population.

AB - Background: Delirium is a common geriatric syndrome. Few studies have been conducted in nursing home (NH) residents. The aim of this project was to perform a point prevalence study of delirium in Italian NHs. Methods: Data collected in 71 NHs are presented. Inclusion criteria were age ≥65 years and native Italian speaker. Exclusion criteria were coma, aphasia, and end-of-life status. Sociodemographic and medical data were recorded. Delirium was assessed using the Assessment Test for Delirium and Cognitive Impairment (4-AT). Patients with a 4-AT score ≥4 were considered to have delirium. Motor subtype was evaluated using the Delirium Motor Subtype Scale (DMSS). Results: A total of 1,454 patients were evaluated (mean age 84.4 ± 7.4 years, 70.2% female), of whom 535 (36.8%) had delirium. In multivariate logistic regression analysis, variables significantly associated with delirium were education (OR 0.94, 95% CI 0.91-0.97), dementia (OR 3.12, 95% CI 2.38-4.09), functional dependence (OR 6.13, 95% CI 3.08-12.19 for ADL score 0; OR 1.99, 95% CI 1.03-3.84 for ADL score 1-5), malnutrition (OR 4.87, 95% CI 2.68-8.84), antipsychotics (OR 2.40, 95% CI 1.81-3.18), and physical restraints (OR 2.48, 95% CI 1.71-3.59). Conclusion: Delirium is common in older NH residents. Simple assessment tools might facilitate its recognition in this vulnerable population.

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