Abstract
Objective: Sensory deficits are important risk factors for delirium but have been investigated in single-center studies and single clinical settings. This multicenter study aims to evaluate the association between hearing and visual impairment or bi-sensory impairment (visual and hearing impairment) and delirium. Design: Cross-sectional study nested in the 2017 “Delirium Day” project. Setting and Participants: Patients 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes, and hospices in Italy. Methods: Delirium was assessed with the 4AT (a short tool for delirium assessment) and sensory deficits with a clinical evaluation. We assessed the association between delirium, hearing and visual impairment in multivariable logistic regression models, adjusting for: Model 1, we included predisposing factors for delirium (ie, dementia, weight loss and autonomy in the activities of daily living); Model 2, we added to Model 1 variables, which could be considered precipitating factors for delirium (ie, psychoactive drugs and urinary catheters). Results: A total of 3038 patients were included; delirium prevalence was 25%. Patients with delirium had a higher prevalence of hearing impairment (30.5% vs 18%; P < .001), visual impairment (24.2% vs 15.7%; P < .01) and bi-sensory impairment (16.2% vs 7.5%) compared with those without delirium. In the multivariable logistic regression analysis, the presence of bi-sensory impairment was associated with delirium in Model 1 [odds ratio (OR) 1.5, confidence interval (CI) 1.2–2.1; P = .00] and in Model 2 (OR 1.4; CI 1.1–1.9; P = .02), whereas the presence of visual and hearing impairment alone was not associated with delirium either in Model 1 (OR 0.8; CI 0.6–1.2, P = .36; OR 1.1; CI 0.8–1.4; P = .42) or in Model 2 (OR 0.8, CI 0.6–1.2, P = .27; OR 1.1, CI 0.8–1.4, P = .63). Conclusions and implications: Our findings support the importance of routine screening and specific interventions by a multidisciplinary team to implement optimal management of sensory impairments and hence prevention and the management of the patients with delirium.
| Original language | English |
|---|---|
| Journal | Journal of the American Medical Directors Association |
| Volume | 22 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Jun 2021 |
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Visual and Hearing Impairment Are Associated With Delirium in Hospitalized Patients: Results of a Multisite Prevalence Study. / Morandi, A.; Inzitari, M.; Udina, C.; Gual, N.; Mota, M.; Tassistro, E.; Andreano, A.; Cherubini, A.; Gentile, S.; Mossello, E.; Marengoni, A.; Olivé, A.; Riba, F.; Ruiz, D.; de Jaime, E.; Bellelli, G.; Tarasconi, A.; Sella, M.; Auriemma, S.; Paternò, G.; Faggian, G.; Lucarelli, C.; De Grazia, N.; Alberto, C.; Margola, A.; Porcella, L.; Nardiello, I.; Chimenti, E.; Zeni, M.; Giani, A.; Famularo, S.; Romairone, E.; Minaglia, C.; Ceccotti, C.; Guerra, G.; Mantovani, G.; Monacelli, F.; Candiani, T.; Ballestrero, A.; Santolini, F.; Rosso, M.; Bono, V.; Sibilla, S.; Dal Santo, P.; Ceci, M.; Barone, P.; Schirinzi, T.; Formenti, A.; Nastasi, G.; Isaia, G.; Gonella, D.; Battuello, A.; Casson, S.; Calvani, D.; Boni, F.; Ciaccio, A.; Rosa, R.; Sanna, G.; Manfredini, S.; Cortese, L.; Rizzo, M.; Prestano, R.; Greco, A.; Lauriola, M.; Gelosa, G.; Piras, V.; Arena, M.; Cosenza, D.; Bellomo, A.; LaMontagna, M.; Gabbani, L.; Lambertucci, L.; Perego, S.; Parati, G.; Basile, G.; Gallina, V.; Pilone, G.; Giudice, C.; Di, F.; Pietrogrande, L.; De, B.; Mosca, M.; Corazzin, I.; Rossi, P.; Nunziata, V.; D'Amico, F.; Grippa, A.; Giardini, S.; Barucci, R.; Cossu, A.; Fiorin, L.; Distefano, M.; Lunardelli, M.; Brunori, M.; Ruffini, I.; Abraham, E.; Varutti, A.; Fabbro, E.; Catalano, A.; Martino, G.; Leotta, D.; Marchet, A.; Dell'Aquila, G.; Scrimieri, A.; Davoli, M.; Casella, M.; Cartei, A.; Polidori, G.; Brischetto, D.; Motta, S.; Saponara, R.; Perrone, P.; Russo, G.; Del, D.; Car, C.; Pirina, T.; Franzoni, S.; Cotroneo, A.; Ghiggia, F.; Volpi, G.; Menichetti, C.; Bo, M.; Panico, A.; Calogero, P.; Corvalli, G.; Mauri, M.; Lupia, E.; Manfredini, R.; Fabbian, F.; March, A.; Pedrotti, M.; Veronesi, M.; Strocchi, E.; Borghi, C.; Bianchetti, A.; Crucitti, A.; DiFrancesco, V.; Fontana, G.; Bonanni, L.; Barbone, F.; Serrati, C.; Ballardini, G.; Simoncelli, M.; Ceschia, G.; Scarpa, C.; Brugiolo, R.; Fusco, S.; Ciarambino, T.; Biagini, C.; Tonon, E.; Porta, M.; Venuti, D.; DelSette, M.; Poeta, M.; Barbagallo, G.; Trovato, G.; Delitala, A.; Arosio, P.; Reggiani, F.; Zuliani, G.; Ortolani, B.; Mussio, E.; Girardi, A.; Coin, A.; Ruotolo, G.; Castagna, A.; Masina, M.; Cimino, R.; Pinciaroli, A.; Tripodi, G.; Cannistrà, U.; Cassadonte, F.; Vatrano, M.; Scaglione, L.; Fogliacco, P.; Muzzuilini, C.; Romano, F.; Padovani, A.; Rozzini, L.; Cagnin, A.; Fragiacomo, F.; Desideri, G.; Liberatore, E.; Bruni, A.; Orsitto, G.; Franco, M.; Bonfrate, L.; Bonetto, M.; Pizio, N.; Magnani, G.; Cecchetti, G.; Longo, A.; Bubba, V.; Marinan, L.; Cotelli, M.; Turla, M.; Sessa, M.; Abruzzi, L.; Castoldi, G.; LoVetere, D.; Musacchio, C.; Novello, M.; Cavarape, A.; Bini, A.; Leonardi, A.; Seneci, F.; Grimaldi, W.; Fimognari, F.; Bambara, V.; Saitta, A.; Corica, F.; Braga, M.; Ettorre, E.; Camellini, C.; Annoni, G.; Crescenzo, A.; Noro, G.; Turco, R.; Ponzetto, M.; Giuseppe, L.; Mazzei, B.; Maiuri, G.; Costaggiu, D.; Damato, R.; Formilan, M.; Patrizia, G.; Gallucci, M.; Paragona, M.; Bini, P.; Modica, D.; Abati, C.; Clerici, M.; Barbera, I.; NigroImperiale, F.; Manni, A.; Votino, C.; Castiglioni, C.; Di, M.; Degl'Innocenti, M.; Moscatelli, G.; Guerini, S.; Casini, C.; Dini, D.; D'Imporzano, E.; DeNotariis, S.; Bonometti, F.; Paolillo, C.; Riccardi, A.; Tiozzo, A.; DiBari, M.; Vanni, S.; Scarpa, A.; Zara, D.; Ranieri, P.; Alessandro, M.; Di, F.; Pezzoni, D.; Platto, C.; D'Ambrosio, V.; Ivaldi, C.; Milia, P.; DeSalvo, F.; Solaro, C.; Strazzacappa, M.; Cazzadori, M.; Confente, S.; Grasso, M.; Troisi, E.; Guerini, V.; Bernardini, B.; Corsini, C.; Boffelli, S.; Filippi, A.; Delpin, K.; Faraci, B.; Bertoletti, E.; Vannucci, M.; Tesi, F.; Crippa, P.; Malighetti, A.; Bettini, D.; Maltese, F.; Abruzzese, G.; Cosimo, D.; Azzini, M.; Colombo, M.; Procino, G.; Fascendini, S.; Barocco, F.; Del, P.; Mazzone, A.; Riva, E.; Dell'Acqua, D.; Cottino, M.; Vezzadini, G.; Avanzi, S.; Brambilla, C.; Orini, S.; Sgrilli, F.; Mello, A.; Lombardi, L.; Muti, E.; Dijk, B.; Fenu, S.; Pes, C.; Gareri, P.; Passamonte, M.; Rigo, R.; Locusta, L.; Caser, L.; Rosso, G.; Cesarini, S.; Cozzi, R.; Santini, C.; Carbone, P.; Cazzaniga, I.; Lovati, R.; Cantoni, A.; Ranzani, P.; Barra, D.; Pompilio, G.; Dimori, S.; Cernesi, S.; Riccò, C.; Piazzolla, F.; Capittini, E.; Rota, C.; Gottardi, F.; Merla, L.; Barelli, A.; Millul, A.; De, G.; Morrone, G.; Bigolari, M.; Macchi, M.; Zambon, F.; Pizzorni, C.; DiCasaleto, G.; Menculini, G.; Marcacci, M.; Catanese, G.; Sprini, D.; DiCasalet, T.; Bocci, M.; Borga, S.; Caironi, P.; Cat, C.; Cingolani, E.; Avalli, L.; Greco, G.; Citerio, G.; Gandini, L.; Cornara, G.; Lerda, R.; Brazzi, L.; Simeone, F.; Caciorgna, M.; Alampi, D.; Francesconi, S.; Beck, E.; Antonini, B.; Vettoretto, K.; Meggiolaro, M.; Garofalo, E.; Notaro, S.; Varutti, R.; Bassi, F.; Mistraletti, G.; Marino, A.; Rona, R.; Rondelli, E.; Riva, I.; Scapigliati, A.; Cortegiani, A.; Vitale, F.; Pistidda, L.; D'Andrea, R.; Querci, L.; Gnesin, P.; Todeschini, M.; Lugano, M.; Castelli, G.; Ortolani, M.; Cotoia, A.; Maggiore, S.; DiTizio, L.; Graziani, R.; Testa, I.; Ferretti, E.; Castioni, C.; Lombardi, F.; Caserta, R.; Pasqua, M.; Simoncini, S.; Baccarini, F.; Rispoli, M.; Grossi, F.; Cancelliere, L.; Carnelli, M.; Puccini, F.; Biancofiore, G.; Siniscalchi, A.; Laici, C.; Torrini, M.; Pasetti, G.; Palmese, S.; Oggioni, R.; Mangani, V.; Pini, S.; Martelli, M.; Rigo, E.; Zuccalà, F.; Cherri, A.; Spina, R.; Calamai, I.; Petrucci, N.; Caicedo, A.; Ferri, F.; Gritti, P.; Brienza, N.; Fonnesu, R.; Dessena, M.; Fullin, G.; Saggioro, D.
In: Journal of the American Medical Directors Association, Vol. 22, No. 6, 06.2021.Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - Visual and Hearing Impairment Are Associated With Delirium in Hospitalized Patients: Results of a Multisite Prevalence Study
AU - Morandi, A.
AU - Inzitari, M.
AU - Udina, C.
AU - Gual, N.
AU - Mota, M.
AU - Tassistro, E.
AU - Andreano, A.
AU - Cherubini, A.
AU - Gentile, S.
AU - Mossello, E.
AU - Marengoni, A.
AU - Olivé, A.
AU - Riba, F.
AU - Ruiz, D.
AU - de Jaime, E.
AU - Bellelli, G.
AU - Tarasconi, A.
AU - Sella, M.
AU - Auriemma, S.
AU - Paternò, G.
AU - Faggian, G.
AU - Lucarelli, C.
AU - De Grazia, N.
AU - Alberto, C.
AU - Margola, A.
AU - Porcella, L.
AU - Nardiello, I.
AU - Chimenti, E.
AU - Zeni, M.
AU - Giani, A.
AU - Famularo, S.
AU - Romairone, E.
AU - Minaglia, C.
AU - Ceccotti, C.
AU - Guerra, G.
AU - Mantovani, G.
AU - Monacelli, F.
AU - Candiani, T.
AU - Ballestrero, A.
AU - Santolini, F.
AU - Rosso, M.
AU - Bono, V.
AU - Sibilla, S.
AU - Dal Santo, P.
AU - Ceci, M.
AU - Barone, P.
AU - Schirinzi, T.
AU - Formenti, A.
AU - Nastasi, G.
AU - Isaia, G.
AU - Gonella, D.
AU - Battuello, A.
AU - Casson, S.
AU - Calvani, D.
AU - Boni, F.
AU - Ciaccio, A.
AU - Rosa, R.
AU - Sanna, G.
AU - Manfredini, S.
AU - Cortese, L.
AU - Rizzo, M.
AU - Prestano, R.
AU - Greco, A.
AU - Lauriola, M.
AU - Gelosa, G.
AU - Piras, V.
AU - Arena, M.
AU - Cosenza, D.
AU - Bellomo, A.
AU - LaMontagna, M.
AU - Gabbani, L.
AU - Lambertucci, L.
AU - Perego, S.
AU - Parati, G.
AU - Basile, G.
AU - Gallina, V.
AU - Pilone, G.
AU - Giudice, C.
AU - Di, F.
AU - Pietrogrande, L.
AU - De, B.
AU - Mosca, M.
AU - Corazzin, I.
AU - Rossi, P.
AU - Nunziata, V.
AU - D'Amico, F.
AU - Grippa, A.
AU - Giardini, S.
AU - Barucci, R.
AU - Cossu, A.
AU - Fiorin, L.
AU - Distefano, M.
AU - Lunardelli, M.
AU - Brunori, M.
AU - Ruffini, I.
AU - Abraham, E.
AU - Varutti, A.
AU - Fabbro, E.
AU - Catalano, A.
AU - Martino, G.
AU - Leotta, D.
AU - Marchet, A.
AU - Dell'Aquila, G.
AU - Scrimieri, A.
AU - Davoli, M.
AU - Casella, M.
AU - Cartei, A.
AU - Polidori, G.
AU - Brischetto, D.
AU - Motta, S.
AU - Saponara, R.
AU - Perrone, P.
AU - Russo, G.
AU - Del, D.
AU - Car, C.
AU - Pirina, T.
AU - Franzoni, S.
AU - Cotroneo, A.
AU - Ghiggia, F.
AU - Volpi, G.
AU - Menichetti, C.
AU - Bo, M.
AU - Panico, A.
AU - Calogero, P.
AU - Corvalli, G.
AU - Mauri, M.
AU - Lupia, E.
AU - Manfredini, R.
AU - Fabbian, F.
AU - March, A.
AU - Pedrotti, M.
AU - Veronesi, M.
AU - Strocchi, E.
AU - Borghi, C.
AU - Bianchetti, A.
AU - Crucitti, A.
AU - DiFrancesco, V.
AU - Fontana, G.
AU - Bonanni, L.
AU - Barbone, F.
AU - Serrati, C.
AU - Ballardini, G.
AU - Simoncelli, M.
AU - Ceschia, G.
AU - Scarpa, C.
AU - Brugiolo, R.
AU - Fusco, S.
AU - Ciarambino, T.
AU - Biagini, C.
AU - Tonon, E.
AU - Porta, M.
AU - Venuti, D.
AU - DelSette, M.
AU - Poeta, M.
AU - Barbagallo, G.
AU - Trovato, G.
AU - Delitala, A.
AU - Arosio, P.
AU - Reggiani, F.
AU - Zuliani, G.
AU - Ortolani, B.
AU - Mussio, E.
AU - Girardi, A.
AU - Coin, A.
AU - Ruotolo, G.
AU - Castagna, A.
AU - Masina, M.
AU - Cimino, R.
AU - Pinciaroli, A.
AU - Tripodi, G.
AU - Cannistrà, U.
AU - Cassadonte, F.
AU - Vatrano, M.
AU - Scaglione, L.
AU - Fogliacco, P.
AU - Muzzuilini, C.
AU - Romano, F.
AU - Padovani, A.
AU - Rozzini, L.
AU - Cagnin, A.
AU - Fragiacomo, F.
AU - Desideri, G.
AU - Liberatore, E.
AU - Bruni, A.
AU - Orsitto, G.
AU - Franco, M.
AU - Bonfrate, L.
AU - Bonetto, M.
AU - Pizio, N.
AU - Magnani, G.
AU - Cecchetti, G.
AU - Longo, A.
AU - Bubba, V.
AU - Marinan, L.
AU - Cotelli, M.
AU - Turla, M.
AU - Sessa, M.
AU - Abruzzi, L.
AU - Castoldi, G.
AU - LoVetere, D.
AU - Musacchio, C.
AU - Novello, M.
AU - Cavarape, A.
AU - Bini, A.
AU - Leonardi, A.
AU - Seneci, F.
AU - Grimaldi, W.
AU - Fimognari, F.
AU - Bambara, V.
AU - Saitta, A.
AU - Corica, F.
AU - Braga, M.
AU - Ettorre, E.
AU - Camellini, C.
AU - Annoni, G.
AU - Crescenzo, A.
AU - Noro, G.
AU - Turco, R.
AU - Ponzetto, M.
AU - Giuseppe, L.
AU - Mazzei, B.
AU - Maiuri, G.
AU - Costaggiu, D.
AU - Damato, R.
AU - Formilan, M.
AU - Patrizia, G.
AU - Gallucci, M.
AU - Paragona, M.
AU - Bini, P.
AU - Modica, D.
AU - Abati, C.
AU - Clerici, M.
AU - Barbera, I.
AU - NigroImperiale, F.
AU - Manni, A.
AU - Votino, C.
AU - Castiglioni, C.
AU - Di, M.
AU - Degl'Innocenti, M.
AU - Moscatelli, G.
AU - Guerini, S.
AU - Casini, C.
AU - Dini, D.
AU - D'Imporzano, E.
AU - DeNotariis, S.
AU - Bonometti, F.
AU - Paolillo, C.
AU - Riccardi, A.
AU - Tiozzo, A.
AU - DiBari, M.
AU - Vanni, S.
AU - Scarpa, A.
AU - Zara, D.
AU - Ranieri, P.
AU - Alessandro, M.
AU - Di, F.
AU - Pezzoni, D.
AU - Platto, C.
AU - D'Ambrosio, V.
AU - Ivaldi, C.
AU - Milia, P.
AU - DeSalvo, F.
AU - Solaro, C.
AU - Strazzacappa, M.
AU - Cazzadori, M.
AU - Confente, S.
AU - Grasso, M.
AU - Troisi, E.
AU - Guerini, V.
AU - Bernardini, B.
AU - Corsini, C.
AU - Boffelli, S.
AU - Filippi, A.
AU - Delpin, K.
AU - Faraci, B.
AU - Bertoletti, E.
AU - Vannucci, M.
AU - Tesi, F.
AU - Crippa, P.
AU - Malighetti, A.
AU - Bettini, D.
AU - Maltese, F.
AU - Abruzzese, G.
AU - Cosimo, D.
AU - Azzini, M.
AU - Colombo, M.
AU - Procino, G.
AU - Fascendini, S.
AU - Barocco, F.
AU - Del, P.
AU - Mazzone, A.
AU - Riva, E.
AU - Dell'Acqua, D.
AU - Cottino, M.
AU - Vezzadini, G.
AU - Avanzi, S.
AU - Brambilla, C.
AU - Orini, S.
AU - Sgrilli, F.
AU - Mello, A.
AU - Lombardi, L.
AU - Muti, E.
AU - Dijk, B.
AU - Fenu, S.
AU - Pes, C.
AU - Gareri, P.
AU - Passamonte, M.
AU - Rigo, R.
AU - Locusta, L.
AU - Caser, L.
AU - Rosso, G.
AU - Cesarini, S.
AU - Cozzi, R.
AU - Santini, C.
AU - Carbone, P.
AU - Cazzaniga, I.
AU - Lovati, R.
AU - Cantoni, A.
AU - Ranzani, P.
AU - Barra, D.
AU - Pompilio, G.
AU - Dimori, S.
AU - Cernesi, S.
AU - Riccò, C.
AU - Piazzolla, F.
AU - Capittini, E.
AU - Rota, C.
AU - Gottardi, F.
AU - Merla, L.
AU - Barelli, A.
AU - Millul, A.
AU - De, G.
AU - Morrone, G.
AU - Bigolari, M.
AU - Macchi, M.
AU - Zambon, F.
AU - Pizzorni, C.
AU - DiCasaleto, G.
AU - Menculini, G.
AU - Marcacci, M.
AU - Catanese, G.
AU - Sprini, D.
AU - DiCasalet, T.
AU - Bocci, M.
AU - Borga, S.
AU - Caironi, P.
AU - Cat, C.
AU - Cingolani, E.
AU - Avalli, L.
AU - Greco, G.
AU - Citerio, G.
AU - Gandini, L.
AU - Cornara, G.
AU - Lerda, R.
AU - Brazzi, L.
AU - Simeone, F.
AU - Caciorgna, M.
AU - Alampi, D.
AU - Francesconi, S.
AU - Beck, E.
AU - Antonini, B.
AU - Vettoretto, K.
AU - Meggiolaro, M.
AU - Garofalo, E.
AU - Notaro, S.
AU - Varutti, R.
AU - Bassi, F.
AU - Mistraletti, G.
AU - Marino, A.
AU - Rona, R.
AU - Rondelli, E.
AU - Riva, I.
AU - Scapigliati, A.
AU - Cortegiani, A.
AU - Vitale, F.
AU - Pistidda, L.
AU - D'Andrea, R.
AU - Querci, L.
AU - Gnesin, P.
AU - Todeschini, M.
AU - Lugano, M.
AU - Castelli, G.
AU - Ortolani, M.
AU - Cotoia, A.
AU - Maggiore, S.
AU - DiTizio, L.
AU - Graziani, R.
AU - Testa, I.
AU - Ferretti, E.
AU - Castioni, C.
AU - Lombardi, F.
AU - Caserta, R.
AU - Pasqua, M.
AU - Simoncini, S.
AU - Baccarini, F.
AU - Rispoli, M.
AU - Grossi, F.
AU - Cancelliere, L.
AU - Carnelli, M.
AU - Puccini, F.
AU - Biancofiore, G.
AU - Siniscalchi, A.
AU - Laici, C.
AU - Torrini, M.
AU - Pasetti, G.
AU - Palmese, S.
AU - Oggioni, R.
AU - Mangani, V.
AU - Pini, S.
AU - Martelli, M.
AU - Rigo, E.
AU - Zuccalà, F.
AU - Cherri, A.
AU - Spina, R.
AU - Calamai, I.
AU - Petrucci, N.
AU - Caicedo, A.
AU - Ferri, F.
AU - Gritti, P.
AU - Brienza, N.
AU - Fonnesu, R.
AU - Dessena, M.
AU - Fullin, G.
AU - Saggioro, D.
N1 - Export Date: 19 February 2021
PY - 2021/6
Y1 - 2021/6
N2 - Objective: Sensory deficits are important risk factors for delirium but have been investigated in single-center studies and single clinical settings. This multicenter study aims to evaluate the association between hearing and visual impairment or bi-sensory impairment (visual and hearing impairment) and delirium. Design: Cross-sectional study nested in the 2017 “Delirium Day” project. Setting and Participants: Patients 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes, and hospices in Italy. Methods: Delirium was assessed with the 4AT (a short tool for delirium assessment) and sensory deficits with a clinical evaluation. We assessed the association between delirium, hearing and visual impairment in multivariable logistic regression models, adjusting for: Model 1, we included predisposing factors for delirium (ie, dementia, weight loss and autonomy in the activities of daily living); Model 2, we added to Model 1 variables, which could be considered precipitating factors for delirium (ie, psychoactive drugs and urinary catheters). Results: A total of 3038 patients were included; delirium prevalence was 25%. Patients with delirium had a higher prevalence of hearing impairment (30.5% vs 18%; P < .001), visual impairment (24.2% vs 15.7%; P < .01) and bi-sensory impairment (16.2% vs 7.5%) compared with those without delirium. In the multivariable logistic regression analysis, the presence of bi-sensory impairment was associated with delirium in Model 1 [odds ratio (OR) 1.5, confidence interval (CI) 1.2–2.1; P = .00] and in Model 2 (OR 1.4; CI 1.1–1.9; P = .02), whereas the presence of visual and hearing impairment alone was not associated with delirium either in Model 1 (OR 0.8; CI 0.6–1.2, P = .36; OR 1.1; CI 0.8–1.4; P = .42) or in Model 2 (OR 0.8, CI 0.6–1.2, P = .27; OR 1.1, CI 0.8–1.4, P = .63). Conclusions and implications: Our findings support the importance of routine screening and specific interventions by a multidisciplinary team to implement optimal management of sensory impairments and hence prevention and the management of the patients with delirium.
AB - Objective: Sensory deficits are important risk factors for delirium but have been investigated in single-center studies and single clinical settings. This multicenter study aims to evaluate the association between hearing and visual impairment or bi-sensory impairment (visual and hearing impairment) and delirium. Design: Cross-sectional study nested in the 2017 “Delirium Day” project. Setting and Participants: Patients 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes, and hospices in Italy. Methods: Delirium was assessed with the 4AT (a short tool for delirium assessment) and sensory deficits with a clinical evaluation. We assessed the association between delirium, hearing and visual impairment in multivariable logistic regression models, adjusting for: Model 1, we included predisposing factors for delirium (ie, dementia, weight loss and autonomy in the activities of daily living); Model 2, we added to Model 1 variables, which could be considered precipitating factors for delirium (ie, psychoactive drugs and urinary catheters). Results: A total of 3038 patients were included; delirium prevalence was 25%. Patients with delirium had a higher prevalence of hearing impairment (30.5% vs 18%; P < .001), visual impairment (24.2% vs 15.7%; P < .01) and bi-sensory impairment (16.2% vs 7.5%) compared with those without delirium. In the multivariable logistic regression analysis, the presence of bi-sensory impairment was associated with delirium in Model 1 [odds ratio (OR) 1.5, confidence interval (CI) 1.2–2.1; P = .00] and in Model 2 (OR 1.4; CI 1.1–1.9; P = .02), whereas the presence of visual and hearing impairment alone was not associated with delirium either in Model 1 (OR 0.8; CI 0.6–1.2, P = .36; OR 1.1; CI 0.8–1.4; P = .42) or in Model 2 (OR 0.8, CI 0.6–1.2, P = .27; OR 1.1, CI 0.8–1.4, P = .63). Conclusions and implications: Our findings support the importance of routine screening and specific interventions by a multidisciplinary team to implement optimal management of sensory impairments and hence prevention and the management of the patients with delirium.
U2 - 10.1016/j.jamda.2020.09.032
DO - 10.1016/j.jamda.2020.09.032
M3 - Article
VL - 22
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
SN - 1525-8610
IS - 6
ER -