Characteristics of institutionalized older patients with delirium newly admitted to an acute care hospital

Abstract

Objectives

The aims of this study were to describe the characteristics of institutionalized older patients with delirium and to explore whether the factors associated with delirium differed according to the severity of the prior cognitive impairment of newly admitted older patients.

Methods

This is a secondary analysis study (cross-sectional) of institutionalized older patients newly admitted to an acute care hospital (n = 104). We screened patients for delirium upon their admission, using the Confusion Assessment Method.

Results

Of the 104 cognitively impaired older patients included in the study, 68% had delirium. We identified the following as characteristic of older patients with delirium: male sex (p = 0.0259), being admitted from a nursing home (p = 0.0269), lower MMSE score at admission (p = 0.0001), severe illness (p = 0.0001), lower functional autonomy (BI: p = 0.0001; IADL: p = 0.0089), bladder (p = 0.0018) and bowel (p = 0.0276) incontinence, and physical restraints (p = 0.0003). Apart from hearing impairment, we found that remaining factors were similarly distributed among older patients with mild, moderate and severe prior cognitive impairment.

Conclusion(s)

The severity of prior cognitive impairment does not appear to influence the distribution of the factors associated with delirium. Hence patients with severe prior cognitive impairment at admission to an acute-care hospital would not require preventive nursing interventions different from those for older patients with mild or moderate impairment.