Environmental Factors Predict the Severity of Delirium Symptoms in Long‐Term Care Residents with and without Delirium. Issue 4 (21st March 2013)

• Record Type: Journal Article
• Authors: McCusker, Jane; Cole, Martin G.; Voyer, Philippe; Vu, Minh; Ciampi, Antonio; Monette, Johanne; Champoux, Nathalie; Belzile, Eric; Dyachenko, Alina
• Is Part Of: Journal of the American Geriatrics Society. Volume 61:Issue 4(2013:Apr.)
• Page Start: 502
• Page End: 511
• Publication Date: 2013-03-21
• Subjects: Geriatrics -- Periodicals; 618.97
• DOI: 10.1111/jgs.12164
• Languages: English
• ISSNs: 0002-8614

Abstract

<abstract abstract-type="main" xml:lang="en" id="jgs12164-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jgs12164-sec-0001" sec-type="section"> <title>Objectives</title> <p>To identify potentially modifiable environmental factors (including number of medications) associated with changes over time in the severity of delirium symptoms and to explore the interactions between these factors and resident baseline vulnerability.</p> </sec> <sec id="jgs12164-sec-0002" sec-type="section"> <title>Design</title> <p>Prospective, observational cohort study.</p> </sec> <sec id="jgs12164-sec-0003" sec-type="section"> <title>Setting</title> <p>Seven long‐term care (LTC) facilities.</p> </sec> <sec id="jgs12164-sec-0004" sec-type="section"> <title>Participants</title> <p>Two hundred seventy‐two LTC residents aged 65 and older with and without delirium.</p> </sec> <sec id="jgs12164-sec-0005" sec-type="section"> <title>Measurements</title> <p>Weekly assessments (for up to 6 months) of the severity of delirium symptoms using the Delirium Index (DI), environmental risk factors, and number of medications. Baseline vulnerability measures included a diagnosis of dementia and a delirium risk score. Associations between environmental factors, medications, and weekly changes in DI were analyzed using a general linear model with correlated errors.</p> </sec> <sec id="jgs12164-sec-0006" sec-type="section"> <title>Results</title> <p>Six potentially modifiable environmental factors predicted weekly changes in DI (absence of reading glasses, aids to orientation, family member, and glass of water and presence of bed rails and other restraints) as did the prescription of two or more new medications. Residents with dementia appeared to be more sensitive to the effects of these factors.</p> </sec> <sec id="jgs12164-sec-0007" sec-type="section"> <title>Conclusion</title> <p>Six environmental factors and prescription of two or more new medications predicted changes in the severity of delirium symptoms. These risk factors are potentially modifiable through improved LTC clinical practices.</p> </sec> </abstract>