Older people are at far greater risk of experiencing the debilitating symptoms of delirium during a hospital stay than previously known, according to research led by the University of the Sunshine Coast’s new Professor of Healthy Ageing.
Professor Victoria Traynor said the collaborative study of more than 12,000 hospital cases, believed to be the largest global study of its kind, found that delirium episodes were common among older medical ward patients, with a prevalence of 24 percent.
“On top of that prevalence among patients already admitted, we found a 14 percent incidence of delirium among patients newly admitted to medical wards,” she said.
“Previous studies have focused on older outpatients from medical wards (low prevalence under four percent) or older patients in surgical wards (very high rate of delirium).
“Our results are concerning. They indicate that many older people admitted to hospital for non-surgical treatment, often for conditions related to heart, lungs, stomach and bowels, are also experiencing the complications of delirium. These patients have been neglected.
“The scale of the problem was a surprise and it clearly identifies a need to expand the professional development of healthcare staff to target delirium symptoms and diagnoses in medical ward patients.”
Professor Traynor co-authored the paper, published this month in the International Journal of Nursing Studies, with researchers in Taiwan.
She said the results were particularly important in the lead-up to World Delirium Awareness Day on 12 March.
“Delirium is underdiagnosed and underreported in hospital environments, with symptoms either ignored or mislabelled as dementia or ‘old age’.
Symptoms include short-term confusion, attention deficit, disorientation, memory problems, disinterest in normal activity, daytime lethargy and rapid mood changes.
“Delirium is sudden and temporary unlike dementia which is prolonged and irreversible,” Professor Traynor said.
“However, if left untreated, severe or multiple episodes can actually lead to dementia or death.”
The study also identified five major risk factors: frailty, physical restraint use, prior falls, severe illness and cognitive impairment such as dementia.
“In addition, older age increased the risk whereas years of education mitigated it, which is a common phenomenon for many health conditions,” she said.
Professor Traynor, who is also a Professor of Dementia Research with the Warrigal aged care organisation, said the research insights could inform quick and effective assessment tools to help health providers and family carers recognise delirium earlier, and even prevent it.
“Delirium is preventable and reversible, and a professional such as a nurse doesn’t need expensive equipment to identify the symptoms,” she said.
“It’s about vigilance and eliminating problems as they occur, whether it’s infection, dehydration, stress or environmental factors.”
Professor Traynor has developed freely available online resources with the national Aged Dementia Health Education and Research team to improve delirium awareness by the community and the skills and knowledge of health practitioners and care workers.
Media enquiries: Please contact the Media Team media@usc.edu.au