Contributed by Elizabeth Mahanna-Gabrielli, MD Department of Anesthesiology, Miller School of Medicine, University of Miami, Miami, Florida As a neuroanesthesiologist and intensivist, I’ve seen many frail patients come into the operating room and intensive care unit. During the early years of my career, frailty was informally defined as patient who was elderly, weak, and deconditioned; clinicians […]
Author Archive: NIDUS Blogger
Cognitive Prehabilitation to Prevent Postoperative Delirium
Contributed by Brian O’Gara MD MPH Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, MA Postoperative delirium occurs in 15-50% of older surgical patients, and increases the risk of postoperative complications, hospital mortality and long-term cognitive dysfunction.1 Hospital -based multicomponent interventions can prevent postoperative delirium, but these approaches are only 30-40% effective.2 Therefore, there is […]
Studying Delirium in the Neurocritical Care Unit: Improving Detection and Outcomes in Patients with Stroke
Michael Reznik, MD Assistant Professor of Neurology & Neurosurgery. Brown University, Alpert Medical School I’ve been interested in brain science, consciousness, and cognition for as long as I can remember, and it was through the lens of these interests that I opted to pursue a career in neurology. I found myself especially interested in patients […]
NIDUS article of the month: Effect of aWard-Based Program
Effect of aWard-Based Program on Hospital-Associated Complications and Length of Stay for Older Inpatients The Cluster Randomized CHERISH Trial Alison M. Mudge, MBBS, PhD; Prue McRae, BPhty, MPhil; Merrilyn Banks, PhD; Irene Blackberry, PhD; Sally Barrimore, MNutrDiet; John Endacott, MBBS; Nicholas Graves, PhD; Theresa Green, RN, PhD; Gill Harvey, PhD; Ruth Hubbard, MBBS, MD; Sue […]
Discordance between ICDSC and CAM-ICU-7 as measures of delirium severity in the ICU
Karla D. Krewulak PhD and Kirsten M. Fiest PhD Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada Determination of delirium presence or absence may no longer be sufficient when tools exist to measure a delirium score which may be used to estimate delirium severity. Measurement of delirium severity has been identified as […]
Does Sleep Deprivation Cause Delirium? Exploring the Physiologic Links
Contributed by Shawniqua Williams Roberson, M.Eng., M.D., Departments of Neurology and Biomedical Engineering, Vanderbilt University Medical Center, Nashville, TN. Dr. Williams is a graduate of the 2019 NIDUS Bootcamp. Many of us are familiar with the feeling of not getting enough sleep. Perhaps a storm rattled the windows all night, or the baby couldn’t stop crying. […]
Delirium, Dementia, and Adverse Outcomes
Contributed by Thiago J. Avelino-Silva, MD, PhD*; Flávia B. Garcez, MD, PhD* *Faculty of Medicine, University of São Paulo, São Paulo, Brazil Delirium results from an intricate combination of dozens of possible predisposing and precipitating factors1. Older age, functional dependence, and preexisting cognitive impairment are key determinants for its occurrence, but the latter is a […]
Beyond delirium: The neuropsychiatric dimensions of COVID-19
Contributed by Mark Oldham, MD Assistant Professor – Department of Psychiatry, University of Rochester Medical Center, Rochester, NY The data are clear and, sadly, just as clearly predictable.1,2 COVID-19 has caused delirium—lots of it in fact. Twenty to 30% of older adults with COVID-19 develop delirium, with older adults at higher risk of delirium than […]
Occupational Therapy: Strategies for Delirium Management
Contributed by Evelyn Alvarez1,2,3 & Juan Pablo Saa4 1 Centro de Estudios en Neurociencia Humana y Neuropsicología, Facultad de Psicología, Universidad Diego Portales, Chile, 2 Facultad de Ciencias de la Salud, Universidad Central de Chile, Chile, 3 Departamento de Terapia Ocupacional y Ciencia de la Ocupación, Facultad de Medicina, Universidad de Chile, Chile, 4 Florey […]
Life Changing: Early Delirium Identification and Intervention
Contributed by Kimberly Oosterhouse, PhD, RN, CNE, Loyola University Chicago, NIDUS Pilot Grant Awardee “Kim, I think this is it; she is not responding to me. Can you please come and be with us?” These are the words I woke up to one morning 16 years ago. My distraught grandfather called me from the inpatient […]