Gual N, et al. - Authors studied risk factors for delirium and its outcomes in older adults with and without dementia admitted to a subacute care unit (SCU) after exacerbated chronic conditions. Findings displayed that dementia served as the primary risk factor for delirium in older patients admitted to postacute care, and delirium demonstrated worse clinical and functional outcomes. It was determined that delirium was also relevant in patients with dementia since it exhibited a functional loss at admission and lower functional recovery.

Methods

• This prospective cohort study involved patients ≥65 years old admitted to an SCU for 12 months.
• Data was collected in terms of demographics, comprehensive geriatric assessments, and presence of dementia and delirium at admission.
• Outcomes constituted discharge to previous living situation, mortality, and functional evolution.
• A subgroup analysis examined the specific risk factors for delirium and related outcomes.

Results

• Among 909 patients (mean age [±SD] 85.8 ± 6.7; 60% women, 47.5% with dementia), the development of delirium was seen in 352 (38.7%).
• It was determined that dementia was the main risk factor for delirium (HR [95% CI] 5.2 [3.5-7.7]).
• Age, functional status, and urinary tract infections appeared to be independently related to delirium.
• In dementia patients, only age (HR [95% CI] 1.0 [1.004-1.1]) and being male (HR [95% CI] 1.7 [1.04-2.6]) demonstrated a connection with delirium.
• A correlation was illustrated between delirium with greater mortality (10.8 vs 3.9%; p < 0.001) and greater functional decline in the entire sample (-12.3 vs -6.4 Barthel index points; p < 0.001).
• Greater functional loss (p=0.013) and less functional recovery (p=0.025) were experienced by patients with delirium in the dementia subgroup.