Navigation Links
Delirium in hospitalized adults: Situation critical, no relief available

INDIANAPOLIS Every year as many as seven million adults in the United States experience delirium during hospitalization. In a systematic review of the scientific literature on delirium prevention and treatment, investigators from Indiana University School of Medicine, the Regenstrief Institute and Wishard Health Services found that despite the significant health and financial burdens of delirium for hospitalized adults, no effective way to prevent or treat the condition has been identified.

"Having delirium prolongs the length of a hospital stay, increases the risk of post-hospitalization transfer to a nursing home and doubles the risk of death. We need to identify a safe and effective drug to prevent and treat delirium. With our review we are challenging the scientific community to come up with new therapeutic options," said Malaz Boustani, M.D., senior author of the study which appears in the July 2009 issue of the Journal of General Internal Medicine. Dr. Boustani is a Regenstrief Institute investigator and associate professor of medicine at the IU School of Medicine.

Delirium, experienced by a significant number of older patients in surgical and critical care units and over half of older adults who are hospitalized for broken hips, is a state of confusion in which the individual has undergone a sudden alteration of mental status. Delirium is not dementia, but individuals with dementia are more susceptible to developing delirium during hospitalization than individuals without dementia.

The researchers found that only 13 randomized controlled studies on promising drugs for delirium were conducted from January 1966 to October 2008. These studies identified and evaluated 15 drugs including first and second generation antipsychotics, the drugs currently prescribed by most physicians for patients with delirium. The researchers found that neither older agents nor newer, more expensive medications were effective in preventing delirium. The study also found no difference between antipsychotics in treating delirium. To date, there are no U.S. Food and Drug Administration approved drugs to prevent or manage delirium according to Dr. Boustani.

"Research on delirium is at a point similar to where Alzheimer disease research was 30 years ago. The scientific and policy communities should encourage the FDA to provide guidance regarding the evaluation of potential new therapies for delirium. Hopefully this will promote rapid drug discovery and translation into delivery for patient care," said Dr. Boustani.

For vulnerable older adults only a slight insult, such as developing a urinary tract infection or taking an over-the-counter drug with anti-cholinergic effects (including many popular brands of sleeping pills), may lead to delirium. Less vulnerable individuals may require a more major insult, such as a stroke or heart attack, to trigger delirium, according to Dr. Boustani, who sees patients at the Healthy Aging Brain Center at the IU Center for Senior Health at Wishard.

"Our review found that drugs that affect the sleep-wake cycle, or that manage pain after surgery, may help prevent delirium," said Wishard Health Services pharmacist Noll Campbell, Pharm.D., first author of the study. "However, these treatment targets remain preliminary and require further study before they are accepted into widespread use."


Contact: Cindy Fox Aisen
Indiana University

Related medicine news :

1. AlphaRx and Gaia BioPharma Report Positive Efficacy Results in a Pre-Clinical Trial of GAI-122 Injectable Nano-emulsion for Post-operative Delirium
2. Delirium Episodes Could Hasten Alzheimers-Linked Decline
3. Newer Sedative May Reduce Delirium in ICU Patients
4. Statins Help Prevent Delirium After Heart Surgery
5. Cholesterol Drugs May Raise Post-Op Delirium Risk
6. Gene Tied to Post-Op Delirium in Elderly
7. Hospitalized patients need better understanding of CPR and outcomes
8. P&Gs Downy Fabric Softener Creates the Downy Touch of Comfort Program to Help Provide Quilts to Hospitalized Children
9. Mealtime interaction encourages hospitalized seniors to eat more
10. 20 percent of hospitalized Medicare patients re-admitted to hospital within 30 days
11. 20 percent of hospitalized Medicare patients readmitted to hospital within 30 days
Post Your Comments:
(Date:11/30/2015)... ... 2015 , ... Live Very Well is excited to announce ... . The multi-carrier insurance exchange platform offers individual vision and dental ... compare, quote and match plans to meet their needs. , Beginning December ...
(Date:11/30/2015)... ... November 30, 2015 , ... Until now, the St. ... in the MOMS (Management of Myelomeningocele Study) trial. One of these exclusion criteria was ... a BMI of 18.5 to 24.9 is considered normal, 25 - 29.9 is overweight ...
(Date:11/30/2015)... ... 30, 2015 , ... Stress, anxiety, illness, infection or even a need for ... , Heather Spader, MD, a new pediatric neurosurgeon at Joe DiMaggio Children’s Hospital in ... to tumors. , “Bad headaches that don’t go away, that don’t have ...
(Date:11/30/2015)... ... November 30, 2015 , ... Thermi™, a ... to announce that its ThermiRFR temperature controlled radiofrequency platform has received CE marking ... radiofrequency platform which uses temperature as a clinical endpoint. The technology has ...
(Date:11/30/2015)... ... 30, 2015 , ... MOSI recently added two state-of-the-art augmented reality (AR) experiences ... Jurassic to their collection of interactive exhibits within the Kids In Charge! building. In ... guests to get closer than ever to a range of animals as they drink, ...
Breaking Medicine News(10 mins):
(Date:11/30/2015)... 30, 2015   Royal Philips (NYSE: ... industry,s first MRI guided user interface and automatic scan ... with MR Conditional implants, such as knee and hip ... Radiological Society of North America Annual Meeting (RSNA) . ... diagnostic confidence of this growing patient population. ScanWise Implant ...
(Date:11/30/2015)... India , November 30, 2015 ... 2014, and is expected to grow at a CAGR of 7.6% ... was valued at USD 135.6 million in 2014, and is ... 2020. --> According to the new Market Research Report ... invasive, non-invasive), By End User (Hospitals, ambulatory care, others) - Analysis ...
(Date:11/30/2015)... 2015 2014RestatedChange%Turnover 545,575 , 518,852 , 5.2 Cord Blood ... , 9.8 Hospital Management Service Income , ... Medical Insurance Administration Service Income , 2,780 , ... , 89,645 , 94,580 , ... 2,917 , (3.3) Gross Profit 395,857 , ...
Breaking Medicine Technology: