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Nonpharmacological interventions linked to less delirium in elderly

Multicomponent nonpharmacological delirium prevention interventions reduced delirium and falls among elderly patients during hospitalization, according to recently published data.

“Based on our results, approximately 1 million cases of delirium in the hospital could have been prevented by multicomponent nonpharmacological interventions each year, resulting in Medicare cost savings of approximately $10,000 per case prevented or $10 billion per year,” Tammy T. Hshieh, MD, Division of Aging, Brigham and Women’s Hospital, Harvard Medical School, and colleagues wrote.

In a comprehensive, systematic literature review of data obtained from PubMed, Google Scholar, ScienceDirect and the Cochrane Database of Systematic Reviews, researchers identified 14 studies associated with delirium prevention between Jan. 1, 1999 and Dec. 31, 2013. Approximately 4,276 patients, with a mean age of 79.7 years, were included in the study.

Out of the 14 interventional studies, 11 revealed odds of delirium were 53% less in the intervention group than in the control group (OR=0.47; 95% CI, 0.38-0.58). Sixty-two percent fewer intervention patients fell than controls (OR=0.38; 95% CI, 0.25-0.6), according to four examined studies (n=1,038). In nine studies (n=3,358), length of stay was –0.16 day (95% CI; –0.97 to 0.64) shorter in the intervention group. Moreover, in four meta-analyses (n=1,176) discharge to long-term care was 5% lower (OR=0.95; 95% CI, 0.71-1.26) in the intervention group.

“These strategies hold great promise to influence two of the most important and prevalent conditions affecting seniors during hospitalization,” Hshieh and colleagues wrote. “Our systematic review and meta-analysis demonstrate that these interventions decrease the substantial health care and societal burden of delirium incidence and falls, improving quality of life for these patients and their families.”

Disclosure: Hshieh reports the study was partially supported by a grant from the National Institute on Aging. See the study for a full list of the researchers’ relevant financial disclosures.