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Published in: BMC Geriatrics 1/2019

Open Access 01-12-2019 | Care | Debate

An interdisciplinary statement of scientific societies for the advancement of delirium care across Europe (EDA, EANS, EUGMS, COTEC, IPTOP/WCPT)

Authors: Alessandro Morandi, Christian Pozzi, Koen Milisen, Hans Hobbelen, Jennifer M. Bottomley, Alessandro Lanzoni, Verena C. Tatzer, Maria Gracia Carpena, Antonio Cherubini, Anette Ranhoff, Alasdair M. J. MacLullich, Andrew Teodorczuk, Giuseppe Bellelli

Published in: BMC Geriatrics | Issue 1/2019

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Abstract

Background

Delirium is a geriatric syndrome that presents in 1 out of 5 hospitalized older patients. It is also common in the community, in hospices, and in nursing homes. Delirium prevalence varies according to clinical setting, with rates of under 5% in minor elective surgery but up to 80% in intensive care unit patients. Delirium has severe adverse consequences, but despite this and its high prevalence, it remains undetected in the majority of cases. Optimal delirium care requires an interdisciplinary, multi-dimensional diagnostic and therapeutic approach involving doctors, nurses, physiotherapists, and occupational therapists. However, there are still important gaps in the knowledge and management of this syndrome.

Main body

The objective of this paper is to promote the interdisciplinary approach in the prevention and management of delirium as endorsed by a delirium society (European Delirium Association, EDA), a geriatrics society (European Geriatric Medicine Society, EuGMS), a nursing society (European Academy of Nursing Science, EANS), an occupational therapy society (Council of Occupational Therapists for European Countries, COTEC), and a physiotherapy society (International Association of Physical Therapists working with Older People of the World Confederation for Physical Therapy, IPTOP/WCPT).

Short conclusion

In this paper we have strongly promoted and supported interdisciplinary collaboration underlying the necessity of increasing communication among scientific societies. We have also provided suggestions on how to fill the current gaps via improvements in undergraduate and postgraduate delirium education among European Countries.
Literature
1.
go back to reference American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). Arlington; 2013. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). Arlington; 2013.
2.
go back to reference Flaherty JH, Rudolph J, Shay K, Kamholz B, Boockvar KS, Shaughnessy M, et al. Delirium is a serious and under-recognized problem: why assessment of mental status should be the sixth vital sign. J Am Med Dir Assoc. 2007;8(5):273–5.PubMedCrossRef Flaherty JH, Rudolph J, Shay K, Kamholz B, Boockvar KS, Shaughnessy M, et al. Delirium is a serious and under-recognized problem: why assessment of mental status should be the sixth vital sign. J Am Med Dir Assoc. 2007;8(5):273–5.PubMedCrossRef
3.
go back to reference Bellelli G, Morandi A, Di Santo SG, Mazzone A, Cherubini A, Mossello E, et al. “Delirium Day”: a nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool. BMC Med. 2016;14(1):106.PubMedPubMedCentralCrossRef Bellelli G, Morandi A, Di Santo SG, Mazzone A, Cherubini A, Mossello E, et al. “Delirium Day”: a nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool. BMC Med. 2016;14(1):106.PubMedPubMedCentralCrossRef
4.
go back to reference Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet. 2014;383(9920):911–22.PubMedCrossRef Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet. 2014;383(9920):911–22.PubMedCrossRef
5.
go back to reference de Lange E, Verhaak PF, van der Meer K. Prevalence, presentation and prognosis of delirium in older people in the population, at home and in long term care: a review. Int J Geriatr Psychiatry. 2013;28(2):127–34.PubMedCrossRef de Lange E, Verhaak PF, van der Meer K. Prevalence, presentation and prognosis of delirium in older people in the population, at home and in long term care: a review. Int J Geriatr Psychiatry. 2013;28(2):127–34.PubMedCrossRef
6.
go back to reference Kiely DK, Bergmann MA, Murphy KM, Jones RN, Orav EJ, Marcantonio ER. Delirium among newly admitted postacute facility patients: prevalence, symptoms, and severity. J Gerontol A Biol Sci Med Sci. 2003;58(5):M441–5.PubMedCrossRef Kiely DK, Bergmann MA, Murphy KM, Jones RN, Orav EJ, Marcantonio ER. Delirium among newly admitted postacute facility patients: prevalence, symptoms, and severity. J Gerontol A Biol Sci Med Sci. 2003;58(5):M441–5.PubMedCrossRef
7.
go back to reference Marcantonio ER, Simon SE, Bergmann MA, Jones RN, Murphy KM, Morris JN. Delirium symptoms in post-acute care: prevalent, persistent, and associated with poor functional recovery. J Am Geriatr Soc. 2003;51(1):4–9.PubMedCrossRef Marcantonio ER, Simon SE, Bergmann MA, Jones RN, Murphy KM, Morris JN. Delirium symptoms in post-acute care: prevalent, persistent, and associated with poor functional recovery. J Am Geriatr Soc. 2003;51(1):4–9.PubMedCrossRef
8.
go back to reference Davis DH, Barnes LE, Stephan BC, MacLullich AM, Meagher D, Copeland J, et al. The descriptive epidemiology of delirium symptoms in a large population-based cohort study: results from the Medical Research Council cognitive function and ageing study (MRC CFAS). BMC Geriatr. 2014;14:87.PubMedPubMedCentralCrossRef Davis DH, Barnes LE, Stephan BC, MacLullich AM, Meagher D, Copeland J, et al. The descriptive epidemiology of delirium symptoms in a large population-based cohort study: results from the Medical Research Council cognitive function and ageing study (MRC CFAS). BMC Geriatr. 2014;14:87.PubMedPubMedCentralCrossRef
9.
go back to reference Addesi D, Maio R, Smirne N, Lagana V, Altomari N, Puccio G, et al. Prevalence of delirium in a population of elderly outpatients with dementia: a retrospective study. J Alzheimers Dis. 2018;61(1):251–7.PubMedCrossRef Addesi D, Maio R, Smirne N, Lagana V, Altomari N, Puccio G, et al. Prevalence of delirium in a population of elderly outpatients with dementia: a retrospective study. J Alzheimers Dis. 2018;61(1):251–7.PubMedCrossRef
10.
go back to reference Davis DH, Muniz-Terrera G, Keage HA, Stephan BC, Fleming J, Ince PG, et al. Association of Delirium with Cognitive Decline in late life: a Neuropathologic study of 3 population-based cohort studies. JAMA Psychiatry. 2017;74:244–51.PubMedPubMedCentralCrossRef Davis DH, Muniz-Terrera G, Keage HA, Stephan BC, Fleming J, Ince PG, et al. Association of Delirium with Cognitive Decline in late life: a Neuropathologic study of 3 population-based cohort studies. JAMA Psychiatry. 2017;74:244–51.PubMedPubMedCentralCrossRef
11.
go back to reference Morandi A, Davis D, Fick D, Turco R, Boustani M, Lucchi E, et al. Delirium superimposed on dementia strongly predicts worse outcomes in older rehabilitation inpatients. J Am Med Dir Assoc. 2014;15(5):349–54.PubMedPubMedCentralCrossRef Morandi A, Davis D, Fick D, Turco R, Boustani M, Lucchi E, et al. Delirium superimposed on dementia strongly predicts worse outcomes in older rehabilitation inpatients. J Am Med Dir Assoc. 2014;15(5):349–54.PubMedPubMedCentralCrossRef
12.
go back to reference Morandi A, Lucchi E, Turco R, Morghen S, Guerini F, Santi R, et al. Delirium superimposed on dementia: a quantitative and qualitative evaluation of informal caregivers and health care staff experience. J Psychosom Res. 2015;79(4):272–80.PubMedPubMedCentralCrossRef Morandi A, Lucchi E, Turco R, Morghen S, Guerini F, Santi R, et al. Delirium superimposed on dementia: a quantitative and qualitative evaluation of informal caregivers and health care staff experience. J Psychosom Res. 2015;79(4):272–80.PubMedPubMedCentralCrossRef
13.
go back to reference Morandi A, Lucchi E, Turco R, Morghen S, Guerini F, Santi R, et al. Delirium superimposed on dementia: a quantitative and qualitative evaluation of patient experience. J Psychosom Res. 2015;79(4):281–7.PubMedPubMedCentralCrossRef Morandi A, Lucchi E, Turco R, Morghen S, Guerini F, Santi R, et al. Delirium superimposed on dementia: a quantitative and qualitative evaluation of patient experience. J Psychosom Res. 2015;79(4):281–7.PubMedPubMedCentralCrossRef
14.
go back to reference Witlox J, Eurelings LS, de Jonghe JF, Kalisvaart KJ, Eikelenboom P, van Gool WA. Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: a meta-analysis. JAMA. 2010;304(4):443–51.PubMedCrossRef Witlox J, Eurelings LS, de Jonghe JF, Kalisvaart KJ, Eikelenboom P, van Gool WA. Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: a meta-analysis. JAMA. 2010;304(4):443–51.PubMedCrossRef
15.
go back to reference Ely EW, Shintani A, Truman B, Speroff T, Gordon SM, Harrell FE Jr, et al. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA. 2004;291(14):1753–62.PubMedCrossRef Ely EW, Shintani A, Truman B, Speroff T, Gordon SM, Harrell FE Jr, et al. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA. 2004;291(14):1753–62.PubMedCrossRef
16.
go back to reference Lin SM, Liu CY, Wang CH, Lin HC, Huang CD, Huang PY, et al. The impact of delirium on the survival of mechanically ventilated patients. Crit Care Med. 2004;32(11):2254–9.PubMedCrossRef Lin SM, Liu CY, Wang CH, Lin HC, Huang CD, Huang PY, et al. The impact of delirium on the survival of mechanically ventilated patients. Crit Care Med. 2004;32(11):2254–9.PubMedCrossRef
17.
go back to reference Avelino-Silva TJ, Campora F, Curiati JA, Jacob-Filho W. Association between delirium superimposed on dementia and mortality in hospitalized older adults: a prospective cohort study. PLoS Med. 2017;14(3):e1002264.PubMedPubMedCentralCrossRef Avelino-Silva TJ, Campora F, Curiati JA, Jacob-Filho W. Association between delirium superimposed on dementia and mortality in hospitalized older adults: a prospective cohort study. PLoS Med. 2017;14(3):e1002264.PubMedPubMedCentralCrossRef
18.
go back to reference Dharmarajan K, Swami S, Gou RY, Jones RN, Inouye SK. Pathway from delirium to death: potential in-hospital mediators of excess mortality. J Am Geriatr Soc. 2017;65(5):1026–33.PubMedCrossRef Dharmarajan K, Swami S, Gou RY, Jones RN, Inouye SK. Pathway from delirium to death: potential in-hospital mediators of excess mortality. J Am Geriatr Soc. 2017;65(5):1026–33.PubMedCrossRef
19.
go back to reference Eeles EM, Hubbard RE, White SV, O'Mahony MS, Savva GM, Bayer AJ. Hospital use, institutionalisation and mortality associated with delirium. Age Ageing. 2010;39(4):470–5.PubMedCrossRef Eeles EM, Hubbard RE, White SV, O'Mahony MS, Savva GM, Bayer AJ. Hospital use, institutionalisation and mortality associated with delirium. Age Ageing. 2010;39(4):470–5.PubMedCrossRef
20.
go back to reference Cole MG, Ciampi A, Belzile E, Zhong L. Persistent delirium in older hospital patients: a systematic review of frequency and prognosis. Age Ageing. 2009;38(1):19–26.PubMedCrossRef Cole MG, Ciampi A, Belzile E, Zhong L. Persistent delirium in older hospital patients: a systematic review of frequency and prognosis. Age Ageing. 2009;38(1):19–26.PubMedCrossRef
21.
go back to reference Bellelli G, Mazzola P, Morandi A, Bruni A, Carnevali L, Corsi M, et al. Duration of postoperative delirium is an independent predictor of 6-month mortality in older adults after hip fracture. J Am Geriatr Soc. 2014;62(7):1335–40.PubMedCrossRef Bellelli G, Mazzola P, Morandi A, Bruni A, Carnevali L, Corsi M, et al. Duration of postoperative delirium is an independent predictor of 6-month mortality in older adults after hip fracture. J Am Geriatr Soc. 2014;62(7):1335–40.PubMedCrossRef
22.
go back to reference de la Cruz M, Fan J, Yennu S, Tanco K, Shin S, Wu J, et al. The frequency of missed delirium in patients referred to palliative care in a comprehensive cancer center. Support Care Cancer. 2015;23(8):2427–33.PubMedCrossRef de la Cruz M, Fan J, Yennu S, Tanco K, Shin S, Wu J, et al. The frequency of missed delirium in patients referred to palliative care in a comprehensive cancer center. Support Care Cancer. 2015;23(8):2427–33.PubMedCrossRef
23.
go back to reference Collins N, Blanchard MR, Tookman A, Sampson EL. Detection of delirium in the acute hospital. Age Ageing. 2010;39(1):131–5.PubMedCrossRef Collins N, Blanchard MR, Tookman A, Sampson EL. Detection of delirium in the acute hospital. Age Ageing. 2010;39(1):131–5.PubMedCrossRef
24.
go back to reference Ryan DJ, O'Regan NA, Caoimh RO, Clare J, O'Connor M, Leonard M, et al. Delirium in an adult acute hospital population: predictors, prevalence and detection. BMJ open. 2013;3(1).PubMedPubMedCentralCrossRef Ryan DJ, O'Regan NA, Caoimh RO, Clare J, O'Connor M, Leonard M, et al. Delirium in an adult acute hospital population: predictors, prevalence and detection. BMJ open. 2013;3(1).PubMedPubMedCentralCrossRef
25.
go back to reference Kakuma R, du Fort GG, Arsenault L, Perrault A, Platt RW, Monette J, et al. Delirium in older emergency department patients discharged home: effect on survival. J Am Geriatr Soc. 2003;51(4):443–50.PubMedCrossRef Kakuma R, du Fort GG, Arsenault L, Perrault A, Platt RW, Monette J, et al. Delirium in older emergency department patients discharged home: effect on survival. J Am Geriatr Soc. 2003;51(4):443–50.PubMedCrossRef
26.
go back to reference Bellelli G, Morandi A, Trabucchi M, Caironi G, Coen D, Fraticelli C, et al. Italian intersociety consensus on prevention, diagnosis, and treatment of delirium in hospitalized older persons. Intern Emerg Med. 2018;13(1):113–21.PubMedCrossRef Bellelli G, Morandi A, Trabucchi M, Caironi G, Coen D, Fraticelli C, et al. Italian intersociety consensus on prevention, diagnosis, and treatment of delirium in hospitalized older persons. Intern Emerg Med. 2018;13(1):113–21.PubMedCrossRef
28.
go back to reference Abraha I, Rimland JM, Trotta F, Pierini V, Cruz-Jentoft A, Soiza R, et al. Non-pharmacological interventions to prevent or treat delirium in older patients: clinical practice recommendations the SENATOR-ONTOP series. J Nutr Health Aging. 2016;20(9):927–36.PubMedCrossRef Abraha I, Rimland JM, Trotta F, Pierini V, Cruz-Jentoft A, Soiza R, et al. Non-pharmacological interventions to prevent or treat delirium in older patients: clinical practice recommendations the SENATOR-ONTOP series. J Nutr Health Aging. 2016;20(9):927–36.PubMedCrossRef
29.
go back to reference Siddiqi N, Harrison JK, Clegg A, Teale EA, Young J, Taylor J, et al. Interventions for preventing delirium in hospitalised non-ICU patients. Cochrane Database Syst Rev. 2016;3:CD005563.PubMed Siddiqi N, Harrison JK, Clegg A, Teale EA, Young J, Taylor J, et al. Interventions for preventing delirium in hospitalised non-ICU patients. Cochrane Database Syst Rev. 2016;3:CD005563.PubMed
30.
go back to reference Hshieh TT, Yue J, Oh E, Puelle M, Dowal S, Travison T, et al. Effectiveness of multicomponent nonpharmacological delirium interventions: a meta-analysis. JAMA Intern Med. 2015;175(4):512–20.PubMedPubMedCentralCrossRef Hshieh TT, Yue J, Oh E, Puelle M, Dowal S, Travison T, et al. Effectiveness of multicomponent nonpharmacological delirium interventions: a meta-analysis. JAMA Intern Med. 2015;175(4):512–20.PubMedPubMedCentralCrossRef
31.
go back to reference Martinez F, Tobar C, Hill N. Preventing delirium: should non-pharmacological, multicomponent interventions be used? A systematic review and meta-analysis of the literature. Age Ageing. 2015;44(2):196–204.PubMedCrossRef Martinez F, Tobar C, Hill N. Preventing delirium: should non-pharmacological, multicomponent interventions be used? A systematic review and meta-analysis of the literature. Age Ageing. 2015;44(2):196–204.PubMedCrossRef
32.
go back to reference Bellelli G, Morandi A, Zanetti E, Bozzini M, Lucchi E, Terrasi M, et al. Recognition and management of delirium among doctors, nurses, physiotherapists, and psychologists: an Italian survey. Int Psychogeriatr. 2014;26(12):2093–102.PubMedCrossRef Bellelli G, Morandi A, Zanetti E, Bozzini M, Lucchi E, Terrasi M, et al. Recognition and management of delirium among doctors, nurses, physiotherapists, and psychologists: an Italian survey. Int Psychogeriatr. 2014;26(12):2093–102.PubMedCrossRef
33.
go back to reference Morandi A, Davis D, Taylor JK, Bellelli G, Olofsson B, Kreisel S, et al. Consensus and variations in opinions on delirium care: a survey of European delirium specialists. Int Psychogeriatr. 2013;25(12):2067–75.PubMedPubMedCentralCrossRef Morandi A, Davis D, Taylor JK, Bellelli G, Olofsson B, Kreisel S, et al. Consensus and variations in opinions on delirium care: a survey of European delirium specialists. Int Psychogeriatr. 2013;25(12):2067–75.PubMedPubMedCentralCrossRef
34.
go back to reference Davis D, MacLullich A. Understanding barriers to delirium care: a multicentre survey of knowledge and attitudes amongst UK junior doctors. Age Ageing. 2009;38(5):559–63.PubMedCrossRef Davis D, MacLullich A. Understanding barriers to delirium care: a multicentre survey of knowledge and attitudes amongst UK junior doctors. Age Ageing. 2009;38(5):559–63.PubMedCrossRef
35.
go back to reference Pozzi C, Lucchi E, Lanzoni A, Gentile S, Trabucchi M, Bellelli G, et al. Preliminary evidence of a positive effect of occupational therapy in patients with delirium superimposed on dementia. J Am Med Dir Assoc. 2017;18(12):1091–2.PubMedCrossRef Pozzi C, Lucchi E, Lanzoni A, Gentile S, Trabucchi M, Bellelli G, et al. Preliminary evidence of a positive effect of occupational therapy in patients with delirium superimposed on dementia. J Am Med Dir Assoc. 2017;18(12):1091–2.PubMedCrossRef
36.
go back to reference Alvarez EA, Garrido MA, Tobar EA, Prieto SA, Vergara SO, Briceno CD, et al. Occupational therapy for delirium management in elderly patients without mechanical ventilation in an intensive care unit. A pilot randomized clinical trial. J Crit Care. 2017;40:265.PubMedCrossRef Alvarez EA, Garrido MA, Tobar EA, Prieto SA, Vergara SO, Briceno CD, et al. Occupational therapy for delirium management in elderly patients without mechanical ventilation in an intensive care unit. A pilot randomized clinical trial. J Crit Care. 2017;40:265.PubMedCrossRef
37.
go back to reference Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373(9678):1874–82.PubMedCrossRef Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373(9678):1874–82.PubMedCrossRef
38.
go back to reference Ellis G, Gardner M, Tsiachristas A, Langhorne P, Burke O, Harwood RH, et al. Comprehensive geriatric assessment for older adults admitted to hospital. Cochrane Database Syst Rev. 2017;9:CD006211.PubMed Ellis G, Gardner M, Tsiachristas A, Langhorne P, Burke O, Harwood RH, et al. Comprehensive geriatric assessment for older adults admitted to hospital. Cochrane Database Syst Rev. 2017;9:CD006211.PubMed
39.
go back to reference Deschodt M, Braes T, Flamaing J, Detroyer E, Broos P, Haentjens P, et al. Preventing delirium in older adults with recent hip fracture through multidisciplinary geriatric consultation. J Am Geriatr Soc. 2012;60(4):733–9.PubMedCrossRef Deschodt M, Braes T, Flamaing J, Detroyer E, Broos P, Haentjens P, et al. Preventing delirium in older adults with recent hip fracture through multidisciplinary geriatric consultation. J Am Geriatr Soc. 2012;60(4):733–9.PubMedCrossRef
40.
go back to reference Chodosh J, Weiner M. Implementing models of geriatric Care-behind the scenes. J Am Geriatr Soc. 2018;66(2):364–6.PubMedCrossRef Chodosh J, Weiner M. Implementing models of geriatric Care-behind the scenes. J Am Geriatr Soc. 2018;66(2):364–6.PubMedCrossRef
41.
go back to reference Sloss EM, Solomon DH, Shekelle PG, Young RT, Saliba D, MacLean CH, et al. Selecting target conditions for quality of care improvement in vulnerable older adults. J Am Geriatr Soc. 2000;48(4):363–9.PubMedCrossRef Sloss EM, Solomon DH, Shekelle PG, Young RT, Saliba D, MacLean CH, et al. Selecting target conditions for quality of care improvement in vulnerable older adults. J Am Geriatr Soc. 2000;48(4):363–9.PubMedCrossRef
42.
go back to reference Sockalingam S, Tan A, Hawa R, Pollex H, Abbey S, Hodges BD. Interprofessional education for delirium care: a systematic review. J Interprof Care. 2014;28(4):345–51.PubMedCrossRef Sockalingam S, Tan A, Hawa R, Pollex H, Abbey S, Hodges BD. Interprofessional education for delirium care: a systematic review. J Interprof Care. 2014;28(4):345–51.PubMedCrossRef
43.
go back to reference Teodorczuk A, Mukaetova-Ladinska E, Corbett S, Welfare M. Learning about the patient: an innovative interprofessional dementia and delirium education programme. Clin Teach. 2014;11(7):497–502.PubMedCrossRef Teodorczuk A, Mukaetova-Ladinska E, Corbett S, Welfare M. Learning about the patient: an innovative interprofessional dementia and delirium education programme. Clin Teach. 2014;11(7):497–502.PubMedCrossRef
44.
go back to reference Robles MJ, Esperanza M, Pi-Figueras M, Riera M, Miralles R. Simulation of a clinical scenario with actresses in the classroom: A useful method of learning clinical delirium management. Eur Geriatr Med. 2017;8:474–9.CrossRef Robles MJ, Esperanza M, Pi-Figueras M, Riera M, Miralles R. Simulation of a clinical scenario with actresses in the classroom: A useful method of learning clinical delirium management. Eur Geriatr Med. 2017;8:474–9.CrossRef
45.
go back to reference Martinez-Velilla N, Cadore L, Casas-Herrero A, Idoate-Saralegui F, Izquierdo M. Physical activity and early rehabilitation in hospitalized elderly medical patients: systematic review of randomized clinical trials. J Nutr Health Aging. 2016;20(7):738–51.PubMedCrossRef Martinez-Velilla N, Cadore L, Casas-Herrero A, Idoate-Saralegui F, Izquierdo M. Physical activity and early rehabilitation in hospitalized elderly medical patients: systematic review of randomized clinical trials. J Nutr Health Aging. 2016;20(7):738–51.PubMedCrossRef
46.
go back to reference Ogawa M, Izawa KP, Satomi-Kobayashi S, Kitamura A, Tsuboi Y, Komaki K, et al. Preoperative exercise capacity is associated with the prevalence of postoperative delirium in elective cardiac surgery. Aging Clin Exp Res. 2018;30(1):27–34.PubMedCrossRef Ogawa M, Izawa KP, Satomi-Kobayashi S, Kitamura A, Tsuboi Y, Komaki K, et al. Preoperative exercise capacity is associated with the prevalence of postoperative delirium in elective cardiac surgery. Aging Clin Exp Res. 2018;30(1):27–34.PubMedCrossRef
47.
go back to reference Care P-C. A definition and essential elements. J Am Geriatr Soc. 2016;64(1):15–8.CrossRef Care P-C. A definition and essential elements. J Am Geriatr Soc. 2016;64(1):15–8.CrossRef
48.
go back to reference Fisher AG. Occupation-centred, occupation-based, occupation-focused: same, same or different? Scand J Occup Ther. 2013;20(3):162–73.PubMedCrossRef Fisher AG. Occupation-centred, occupation-based, occupation-focused: same, same or different? Scand J Occup Ther. 2013;20(3):162–73.PubMedCrossRef
49.
go back to reference Graff MJ, Vernooij-Dassen MJ, Thijssen M, Dekker J, Hoefnagels WH, Rikkert MGO. Community based occupational therapy for patients with dementia and their care givers: randomised controlled trial. Bmj. 2006;333(7580):1196.PubMedPubMedCentralCrossRef Graff MJ, Vernooij-Dassen MJ, Thijssen M, Dekker J, Hoefnagels WH, Rikkert MGO. Community based occupational therapy for patients with dementia and their care givers: randomised controlled trial. Bmj. 2006;333(7580):1196.PubMedPubMedCentralCrossRef
50.
go back to reference Bellelli G, Morandi A, Davis DH, Mazzola P, Turco R, Gentile S, et al. Validation of the 4AT, a new instrument for rapid delirium screening: a study in 234 hospitalised older people. Age Ageing. 2014;43(4):496–502.PubMedPubMedCentralCrossRef Bellelli G, Morandi A, Davis DH, Mazzola P, Turco R, Gentile S, et al. Validation of the 4AT, a new instrument for rapid delirium screening: a study in 234 hospitalised older people. Age Ageing. 2014;43(4):496–502.PubMedPubMedCentralCrossRef
51.
go back to reference Chester JG, Beth Harrington M, Rudolph JL. Serial administration of a modified Richmond agitation and sedation scale for delirium screening. J Hosp Med. 2012;7(5):450–3.PubMedCrossRef Chester JG, Beth Harrington M, Rudolph JL. Serial administration of a modified Richmond agitation and sedation scale for delirium screening. J Hosp Med. 2012;7(5):450–3.PubMedCrossRef
52.
go back to reference Scheffer AC, van Munster BC, Schuurmans MJ, de Rooij SE. Assessing severity of delirium by the delirium observation screening scale. Int J Geriatr Psychiatry. 2011;26(3):284–91.PubMedCrossRef Scheffer AC, van Munster BC, Schuurmans MJ, de Rooij SE. Assessing severity of delirium by the delirium observation screening scale. Int J Geriatr Psychiatry. 2011;26(3):284–91.PubMedCrossRef
53.
go back to reference Law M, Baptiste S, Carswell A, McColl MA, Polatajko H, Pollock N. Canadian Occupational Performance Measure (COPM): CAOT publications; 2014. Law M, Baptiste S, Carswell A, McColl MA, Polatajko H, Pollock N. Canadian Occupational Performance Measure (COPM): CAOT publications; 2014.
54.
go back to reference Riopel-Smith R, Kielhofner G. Occupational performance history interview II. Chicago: University of Illinois; 1998. Riopel-Smith R, Kielhofner G. Occupational performance history interview II. Chicago: University of Illinois; 1998.
55.
go back to reference Fisher AG. Occupational therapy intervention process model : a model for planning and implementing top-down, client-centered, and occupation-based interventions; 2009. Fisher AG. Occupational therapy intervention process model : a model for planning and implementing top-down, client-centered, and occupation-based interventions; 2009.
56.
go back to reference Chern J-S, Kielhofner G. de las Heras CG, Magalhaes LC. The volitional questionnaire: psychometric development and practical use. Am J Occup Ther. 1996;50(7):516–25.PubMedCrossRef Chern J-S, Kielhofner G. de las Heras CG, Magalhaes LC. The volitional questionnaire: psychometric development and practical use. Am J Occup Ther. 1996;50(7):516–25.PubMedCrossRef
57.
go back to reference Franchignoni FP, Tesio L, Ricupero C, Martino MT. Trunk control test as an early predictor of stroke rehabilitation outcome. Stroke. 1997;28(7):1382–5.PubMedCrossRef Franchignoni FP, Tesio L, Ricupero C, Martino MT. Trunk control test as an early predictor of stroke rehabilitation outcome. Stroke. 1997;28(7):1382–5.PubMedCrossRef
58.
go back to reference Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986;34(2):119–26.PubMedCrossRef Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986;34(2):119–26.PubMedCrossRef
59.
go back to reference MacKnight C, Rockwood K. A hierarchical assessment of balance and mobility. Age Ageing. 1995;24(2):126–30.PubMedCrossRef MacKnight C, Rockwood K. A hierarchical assessment of balance and mobility. Age Ageing. 1995;24(2):126–30.PubMedCrossRef
60.
go back to reference Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):M85–94.PubMedCrossRef Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):M85–94.PubMedCrossRef
61.
go back to reference Braun T, Grunenberg C, Thiel C, Schulz RJ. Measuring mobility in older hospital patients with cognitive impairment using the de Morton Mobility Index. BMC Geriatr. 2018;18(1):100.PubMedPubMedCentralCrossRef Braun T, Grunenberg C, Thiel C, Schulz RJ. Measuring mobility in older hospital patients with cognitive impairment using the de Morton Mobility Index. BMC Geriatr. 2018;18(1):100.PubMedPubMedCentralCrossRef
62.
go back to reference Mahoney Fi BD. Functional evaluation: the Barthel index. Md State Med J. 1965;14:61–5.PubMed Mahoney Fi BD. Functional evaluation: the Barthel index. Md State Med J. 1965;14:61–5.PubMed
64.
go back to reference Fisher JM, Gordon AL, MacLullich AM, Tullo E, Davis DH, Blundell A, et al. Towards an understanding of why undergraduate teaching about delirium does not guarantee gold-standard practice--results from a UK national survey. Age Ageing. 2015;44(1):166–70.PubMedCrossRef Fisher JM, Gordon AL, MacLullich AM, Tullo E, Davis DH, Blundell A, et al. Towards an understanding of why undergraduate teaching about delirium does not guarantee gold-standard practice--results from a UK national survey. Age Ageing. 2015;44(1):166–70.PubMedCrossRef
65.
go back to reference Bellelli G, Speciale S, Morghen S, Torpilliesi T, Turco R, Trabucchi M. Are fluctuations in motor performance a diagnostic sign of delirium? J Am Med Dir Assoc. 2011;12(8):578–83.PubMedCrossRef Bellelli G, Speciale S, Morghen S, Torpilliesi T, Turco R, Trabucchi M. Are fluctuations in motor performance a diagnostic sign of delirium? J Am Med Dir Assoc. 2011;12(8):578–83.PubMedCrossRef
66.
go back to reference Kiely DK, Jones RN, Bergmann MA, Murphy KM, Orav EJ, Marcantonio ER. Association between delirium resolution and functional recovery among newly admitted postacute facility patients. J Gerontol A Biol Sci Med Sci. 2006;61(2):204–8.PubMedCrossRef Kiely DK, Jones RN, Bergmann MA, Murphy KM, Orav EJ, Marcantonio ER. Association between delirium resolution and functional recovery among newly admitted postacute facility patients. J Gerontol A Biol Sci Med Sci. 2006;61(2):204–8.PubMedCrossRef
67.
go back to reference Irving K, Foreman M. Delirium, nursing practice and the future. Int J Older People Nursing. 2006;1(2):121–7.CrossRef Irving K, Foreman M. Delirium, nursing practice and the future. Int J Older People Nursing. 2006;1(2):121–7.CrossRef
68.
go back to reference World Report on Ageing and Health. Geneva: WHO Press, World Health Organization; 2015. World Report on Ageing and Health. Geneva: WHO Press, World Health Organization; 2015.
69.
go back to reference Inouye SK, Bogardus ST Jr, Charpentier PA, Leo-Summers L, Acampora D, Holford TR, et al. A multicomponent intervention to prevent delirium in hospitalized older patients. N Engl J Med. 1999;340(9):669–76.PubMedCrossRef Inouye SK, Bogardus ST Jr, Charpentier PA, Leo-Summers L, Acampora D, Holford TR, et al. A multicomponent intervention to prevent delirium in hospitalized older patients. N Engl J Med. 1999;340(9):669–76.PubMedCrossRef
70.
go back to reference Rubin FH, Neal K, Fenlon K, Hassan S, Inouye SK. Sustainability and scalability of the hospital elder life program at a community hospital. J Am Geriatr Soc. 2011;59(2):359–65.PubMedPubMedCentralCrossRef Rubin FH, Neal K, Fenlon K, Hassan S, Inouye SK. Sustainability and scalability of the hospital elder life program at a community hospital. J Am Geriatr Soc. 2011;59(2):359–65.PubMedPubMedCentralCrossRef
71.
go back to reference Vidan MT, Sanchez E, Alonso M, Montero B, Ortiz J, Serra JA. An intervention integrated into daily clinical practice reduces the incidence of delirium during hospitalization in elderly patients. J Am Geriatr Soc. 2009;57(11):2029–36.PubMedCrossRef Vidan MT, Sanchez E, Alonso M, Montero B, Ortiz J, Serra JA. An intervention integrated into daily clinical practice reduces the incidence of delirium during hospitalization in elderly patients. J Am Geriatr Soc. 2009;57(11):2029–36.PubMedCrossRef
72.
go back to reference Wand AP. Evaluating the effectiveness of educational interventions to prevent delirium. Australas J Ageing. 2011;30(4):175–85.PubMedCrossRef Wand AP. Evaluating the effectiveness of educational interventions to prevent delirium. Australas J Ageing. 2011;30(4):175–85.PubMedCrossRef
73.
go back to reference Yanamadala M, Wieland D, Heflin MT. Educational interventions to improve recognition of delirium: a systematic review. J Am Geriatr Soc. 2013;61(11):1983–93.PubMedCrossRef Yanamadala M, Wieland D, Heflin MT. Educational interventions to improve recognition of delirium: a systematic review. J Am Geriatr Soc. 2013;61(11):1983–93.PubMedCrossRef
74.
go back to reference Teodorczuk A, Welfare M, Corbett S, Mukaetova-Ladinska E. Developing effective educational approaches for liaison old age psychiatry teams: a literature review of the learning needs of hospital staff in relation to managing the confused older patient. Int Psychogeriatr. 2010;22(6):874–85.PubMedCrossRef Teodorczuk A, Welfare M, Corbett S, Mukaetova-Ladinska E. Developing effective educational approaches for liaison old age psychiatry teams: a literature review of the learning needs of hospital staff in relation to managing the confused older patient. Int Psychogeriatr. 2010;22(6):874–85.PubMedCrossRef
75.
go back to reference Greysen SR. Delirium and the “know-do” gap in acute care for elders. JAMA Intern Med. 2015;175(4):521–2.PubMedCrossRef Greysen SR. Delirium and the “know-do” gap in acute care for elders. JAMA Intern Med. 2015;175(4):521–2.PubMedCrossRef
76.
go back to reference Detroyer E, Dobbels F, Debonnaire D, Irving K, Teodorczuk A, Fick DM, et al. The effect of an interactive delirium e-learning tool on healthcare workers’ delirium recognition, knowledge and strain in caring for delirious patients: a pilot pre-test/post-test study. BMC Medi Educ. 2016;16(1):17.CrossRef Detroyer E, Dobbels F, Debonnaire D, Irving K, Teodorczuk A, Fick DM, et al. The effect of an interactive delirium e-learning tool on healthcare workers’ delirium recognition, knowledge and strain in caring for delirious patients: a pilot pre-test/post-test study. BMC Medi Educ. 2016;16(1):17.CrossRef
77.
go back to reference Detroyer E, Dobbels F, Teodorczuk A, Deschodt M, Depaifve Y, Joosten E, et al. Effect of an interactive E-learning tool for delirium on patient and nursing outcomes in a geriatric hospital setting: findings of a before-after study. BMC Geriatr. 2018;18(1):19.PubMedPubMedCentralCrossRef Detroyer E, Dobbels F, Teodorczuk A, Deschodt M, Depaifve Y, Joosten E, et al. Effect of an interactive E-learning tool for delirium on patient and nursing outcomes in a geriatric hospital setting: findings of a before-after study. BMC Geriatr. 2018;18(1):19.PubMedPubMedCentralCrossRef
78.
go back to reference Teodorczuk A, Mukaetova-Ladinska E, Corbett S, Welfare M. Reconceptualizing models of delirium education: findings of a grounded theory study. Int Psychogeriatr. 2013;25(4):645–55.PubMedCrossRef Teodorczuk A, Mukaetova-Ladinska E, Corbett S, Welfare M. Reconceptualizing models of delirium education: findings of a grounded theory study. Int Psychogeriatr. 2013;25(4):645–55.PubMedCrossRef
79.
go back to reference Copeland C, Fisher J, Teodorczuk A. Development of an international undergraduate curriculum for delirium using a modified delphi process. Age Ageing. 2018;47(1):131–7.PubMedCrossRef Copeland C, Fisher J, Teodorczuk A. Development of an international undergraduate curriculum for delirium using a modified delphi process. Age Ageing. 2018;47(1):131–7.PubMedCrossRef
80.
go back to reference American Psychiatric Association A. Diagnostic and Statistical Manual of Mental Disorders. Arlington: 5th ed: APA; 2013. American Psychiatric Association A. Diagnostic and Statistical Manual of Mental Disorders. Arlington: 5th ed: APA; 2013.
82.
go back to reference Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med. 1990;113(12):941–8.PubMedCrossRef Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med. 1990;113(12):941–8.PubMedCrossRef
83.
go back to reference Detroyer E, Clement PM, Baeten N, Pennemans M, Decruyenaere M, Vandenberghe J, et al. Detection of delirium in palliative care unit patients: a prospective descriptive study of the delirium observation screening scale administered by bedside nurses. Palliat Med. 2014;28(1):79–86.PubMedCrossRef Detroyer E, Clement PM, Baeten N, Pennemans M, Decruyenaere M, Vandenberghe J, et al. Detection of delirium in palliative care unit patients: a prospective descriptive study of the delirium observation screening scale administered by bedside nurses. Palliat Med. 2014;28(1):79–86.PubMedCrossRef
84.
go back to reference Voyer P, Champoux N, Desrosiers J, Landreville P, McCusker J, Monette J, et al. Recognizing acute delirium as part of your routine [RADAR]: a validation study. BMC Nurs. 2015;14:19.PubMedPubMedCentralCrossRef Voyer P, Champoux N, Desrosiers J, Landreville P, McCusker J, Monette J, et al. Recognizing acute delirium as part of your routine [RADAR]: a validation study. BMC Nurs. 2015;14:19.PubMedPubMedCentralCrossRef
85.
go back to reference Rippon D, Milisen K, Detroyer E, Mukaetova-Ladinska E, Harrison B, Schuurmans M, et al. Evaluation of the delirium early monitoring system (DEMS). Int Psychogeriatr. 2016;28(11):1879–87.PubMedCrossRef Rippon D, Milisen K, Detroyer E, Mukaetova-Ladinska E, Harrison B, Schuurmans M, et al. Evaluation of the delirium early monitoring system (DEMS). Int Psychogeriatr. 2016;28(11):1879–87.PubMedCrossRef
86.
go back to reference Yevchak AM, Fick DM, McDowell J, Monroe T, May K, Grove L, et al. Barriers and facilitators to implementing delirium rounds in a clinical trial across three diverse hospital settings. Clin Nurs Res. 2014;23(2):201–15.PubMedCrossRef Yevchak AM, Fick DM, McDowell J, Monroe T, May K, Grove L, et al. Barriers and facilitators to implementing delirium rounds in a clinical trial across three diverse hospital settings. Clin Nurs Res. 2014;23(2):201–15.PubMedCrossRef
87.
go back to reference Hshieh TT, Yang T, Gartaganis SL, Yue J, Inouye SK. Hospital Elder Life Program: Systematic Review and Meta-analysis of Effectiveness. Am J Geriatr Psychiatry. 2018 ;26(10):1015-1033.PubMedCrossRefPubMedCentral Hshieh TT, Yang T, Gartaganis SL, Yue J, Inouye SK. Hospital Elder Life Program: Systematic Review and Meta-analysis of Effectiveness. Am J Geriatr Psychiatry. 2018 ;26(10):1015-1033.PubMedCrossRefPubMedCentral
Metadata
Title
An interdisciplinary statement of scientific societies for the advancement of delirium care across Europe (EDA, EANS, EUGMS, COTEC, IPTOP/WCPT)
Authors
Alessandro Morandi
Christian Pozzi
Koen Milisen
Hans Hobbelen
Jennifer M. Bottomley
Alessandro Lanzoni
Verena C. Tatzer
Maria Gracia Carpena
Antonio Cherubini
Anette Ranhoff
Alasdair M. J. MacLullich
Andrew Teodorczuk
Giuseppe Bellelli
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2019
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-019-1264-2

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