Acute delirium and functional decline in the hospitalized elderly patient

A. M. Murray, S. E. Levkoff, T. T. Wetle, L. Beckett, P. D. Cleary, J. D. Schor, L. A. Lipsitz, J. W. Rowe, D. A. Evans

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241 Scopus citations

Abstract

Background. Delirium is often considered a transient cognitive syndrome. Its effect on long-term physical function, however, has not been well defined. Methods. In a prospective study of 325 hospitalized community and nursing home elderly, we analyzed the effect of inhospital delirium on subsequent physical function. ADL performance was assessed prior to admission, and at 3 and 6 months after hospital discharge. Results. There was a strong univariate (unadjusted) association between incident delirium and functional decline (p < .02) Delirious subjects lost a mean of almost one ADL, as measured 3 months after hospital discharge. Using multivariate linear regression analysis, with adjusted change in function as the dependent variable, delirium persisted as the sole predictor of loss of function (p = .009) at 3 months after discharge. The functional decline persisted at 6 months after hospital discharge. Conclusion. This finding of a nontransient, perhaps permanent consequence of delirium invites reexamination of the definition of delirium from that of an acute, reversible syndrome to one of acute onset with long-term sequelae.

Original languageEnglish (US)
Pages (from-to)M181-M186
JournalJournals of Gerontology
Volume48
Issue number5
DOIs
StatePublished - Jan 1 1993

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