What is the Delirium Bibliography? The searchable Delirium Bibliography page is one of our most popular features, allowing you to quickly gain access to the literature on delirium and acute care of older persons. It is primarily intended for clinicians and researchers interested in exploring these topics. The NIDUS team keeps it updated for you on a monthly basis!
How to Search for Articles: Search by author, title, year, and/or keywords. Each article is indexed by keywords taken from MEDLINE and other relevant databases. Click on the title of the article to read the abstract, journal, etc.
Reference Information
- Title
- Withdrawal versus continuation of long-term antipsychotic drug use for behavioural and psychological symptoms in older people with dementia.
- Authors
- Van Leeuwen, E. Petrovic, M. van Driel, M. L. De Sutter, A. I. M. Vander Stichele, R. Declercq, T. Christiaens, T.
- Year
- 2018
- Journal
- Cochrane Database of Systematic Reviews
- Abstract
Background: Antipsychotic agents are often used to treat neuropsychiatric symptoms (NPS) in people with dementia although there is uncertainty about the effectiveness of their long-term use for this indication and concern that they may cause harm, including higher mortality. When behavioural strategies have failed and treatment with antipsychotic drugs is instituted, regular attempts to withdraw them have been recommended in guidelines. Physicians, nurses and families of older people with dementia may be reluctant to stop antipsychotics, fearing deterioration of NPS. This is an update of a Cochrane Review published in 2013. Objectives: To evaluate whether withdrawal of antipsychotic agents is successful in older people with dementia and NPS in primary care or nursing home settings, to list the different strategies for withdrawal of antipsychotic agents in older participants with dementia and NPS, and to measure the effects of withdrawal of antipsychotic agents on participants’ behaviour and assess safety. Search methods: We searched the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (ALOIS), theCochrane Library, MEDLINE, Embase, PsycINFO, CINAHL, LILACS, clinical trials registries and grey literature sources up to 11 January 2018. Selection criteria: We included all randomised, controlled trials comparing an antipsychotic withdrawal strategy to continuation of antipsychotics in people with dementia who had been treated with an antipsychotic drug for at least three months. Data collection and analysis: We used standard methodological procedures according to the Cochrane Handbook for Systematic Reviews of Interventions. We rated the quality of evidence for each outcome using the GRADE approach. Main results: We included 10 studies involving 632 participants. One new trial (19 participants) was added for this update. One trial was conducted in a community setting, eight in nursing homes and one in both settings. Different types of antipsychotics at varying doses were discontinued in the studies. Both abrupt and gradual withdrawal schedules were used. Reported data were predominantly from studies at low or unclear risk of bias. We included nine trials with 575 randomised participants that used a proxy outcome for overall success of antipsychotic withdrawal. Pooling data was not possible due to heterogeneity of outcome measures used. Based on assessment of seven studies, discontinuation may make little or no difference to whether or not participants complete the study (low-quality evidence). Two trials included only participants with psychosis, agitation or aggression who had responded to antipsychotic treatment. In these two trials, stopping antipsychotics was associated with a higher risk of leaving the study early due to symptomatic relapse or a shorter time to symptomatic relapse. We found low-quality evidence that discontinuation may make little or no difference to overall NPS, measured using various scales (7 trials, 519 participants). There was some evidence from subgroup analyses in two trials that discontinuation may reduce agitation for participants with less severe NPS at baseline, but may be associated with a worsening of NPS in participants with more severe NPS at baseline. None of the studies assessed withdrawal symptoms. Adverse effects of antipsychotics (such as falls) were not systematically assessed. Low-quality evidence showed that discontinuation may have little or no effect on adverse events (5 trials, 381 participants), quality of life (2 trials, 119 participants), or cognitive function (5 trials, 365 participants). There were insufficient data to determine whether discontinuation of antipsychotics has any effect on mortality (very low-quality evidence). Authors’ conclusions: There is low-quality evidence that antipsychotics may be successfully discontinued in older people with dementia and NPS who have been taking antipsychotics for at least three months, and that discontinuation may have little or no important effect on behavioural and psychological symptoms. This i consistent with the observation that most behavioural complications of dementia are intermittent and often do not persist for longer than three months. Discontinuation may have little or no effect on overall cognitive function. Discontinuation may make no difference to adverse events and quality of life. Based on the trials in this review, we are uncertain whether discontinuation of antipsychotics leads to a decrease in mortality. People with psychosis, aggression or agitation who responded well to long-term antipsychotic drug use, or those with more severe NPS at baseline, may benefit behaviourally from continuation of antipsychotics. Discontinuation may reduce agitation for people with mild NPS at baseline. However, these conclusions are based on few studies or small subgroups and further evidence of benefits and harms associated with withdrawal of antipsychotic is required in people with dementia and mild and severe NPS. The overall conclusions of the review have not changed since 2013 and the number of available trials remains low.
- PMID
- Keywords
chlorpromazine
haloperidol
levomepromazine
lorazepam
loxapine
mesoridazine
neuroleptic agent
olanzapine
perphenazine
placebo
risperidone
thioridazine
tiotixene
trifluoperazine
aggression
agitation
akathisia
behavior disorder
blood pressure
body equilibrium
cardiovascular disease
cognition
confusion
dementia
drug fatality
drug megadose
drug response
drug safety
drug withdrawal
extrapyramidal symptom
falling
fracture
heart rate
human
insomnia
long term care
low drug dose
lung disease
mental disease
motor dysfunction
nausea
neurologic disease
nursing home
parkinsonism
physical mobility
primary medical care
priority journal
psychosis
quality of life
relapse
restlessness
review
sedation
side effect
systematic review
tardive dyskinesia
treatment outcome
vomiting
- Page(s)
- Volume
- Issue
- 3
| Title | Authors | Journal | Year | Keywords |
|---|---|---|---|---|
| Subsyndromal delirium and its determinants in elderly patients hospitalized for acute medical illness. | Zuliani G, Bonetti F, Magon S, Prandini S, Sioulis F, D'Amato M, Zampi E, Gasperini B, Cherubini A | The journals of gerontology. Series A, Biological sciences and medical sciences | 2013 |
Acute Disease, Aged, Aged, 80 and over, Aging, blood, Case-Control Studies, Cognition, Delirium, blood, Female, Hospitalization, Humans, Italy, epidemiology, Male, Mental Status Schedule, Oxygen, blood, Prevalence, Risk Factors |
| Thirty-day prevalence of delirium among very old people: a population-based study of very old people living at home and in institutions. | Mathillas J, Olofsson B, Lövheim H, Gustafson Y | Archives of gerontology and geriatrics | 2013 |
Age Factors, Aged, 80 and over, psychology, Delirium, epidemiology, Dementia, epidemiology, Depression, epidemiology, Female, Finland, epidemiology, Health Status, Homes for the Aged, statistics & numerical data, Humans, Independent Living, psychology, Institutionalization, statistics & numerical data, Male, Neuropsychological Tests, Prevalence, Sweden, epidemiology |
| Association between leptin and delirium in elderly inpatients. | Sánchez JC, Ospina JP, González MI | Neuropsychiatric disease and treatment | 2013 | |
| Efficacy and safety of haloperidol versus atypical antipsychotic medications in the treatment of delirium. | Yoon HJ, Park KM, Choi WJ, Choi SH, Park JY, Kim JJ, Seok JH | BMC psychiatry | 2013 |
Aged, Antipsychotic Agents, adverse effects, Benzodiazepines, adverse effects, Delirium, drug therapy, Dibenzothiazepines, adverse effects, Female, Haloperidol, adverse effects, Humans, Male, Middle Aged, Prospective Studies, Risperidone, adverse effects, Treatment Outcome |
| Association between sedating medications and delirium in older inpatients. | Rothberg MB, Herzig SJ, Pekow PS, Avrunin J, Lagu T, Lindenauer PK | Journal of the American Geriatrics Society | 2013 |
Aged, Aged, 80 and over, Antipsychotic Agents, therapeutic use, Delirium, chemically induced, Drug Therapy, Combination, Female, Follow-Up Studies, Humans, Hypnotics and Sedatives, adverse effects, Inpatients, Male, Prevalence, Psychotic Disorders, drug therapy, Retrospective Studies, Risk Factors, United States, epidemiology |
| Effect of intravenous haloperidol on the duration of delirium and coma in critically ill patients (Hope-ICU): a randomised, double-blind, placebo-controlled trial. | Page VJ, Ely EW, Gates S, Zhao XB, Alce T, Shintani A, Jackson J, Perkins GD, McAuley DF | The Lancet. Respiratory medicine | 2013 | |
| Educational interventions to improve recognition of delirium: a systematic review. | Yanamadala M, Wieland D, Heflin MT | Journal of the American Geriatrics Society | 2013 |
Aged, Delirium, diagnosis, Health Personnel, education, Humans |
| Temperature variability during delirium in ICU patients: an observational study. | van der Kooi AW, Kappen TH, Raijmakers RJ, Zaal IJ, Slooter AJ | PloS one | 2013 | |
| Automatic delirium prediction system in a Korean surgical intensive care unit. | Oh SH, Park EJ, Jin Y, Piao J, Lee SM | Nursing in critical care | 2014 | |
| Neuropathogenesis of delirium: review of current etiologic theories and common pathways. | Maldonado JR | The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry | 2013 |
Acetylcholine, metabolism, Aging, Brain, immunology, Chronobiology Disorders, complications, Delirium, etiology, Dopamine, metabolism, Humans, Inflammation, metabolism, Neural Pathways, physiopathology, Oxidative Stress, physiology |
| A longitudinal study of delirium phenomenology indicates widespread neural dysfunction. | Leonard M, Adamis D, Saunders J, Trzepacz P, Meagher D | Palliative & supportive care | 2013 | |
| The pharmacologic treatment of intensive care unit delirium: a systematic review. | Bathula M, Gonzales JP | The Annals of pharmacotherapy | 2013 |
Antipsychotic Agents, therapeutic use, Delirium, drug therapy, Humans, Intensive Care Units |
| Outcome and quality of life in patients with postoperative delirium during an ICU stay following major surgery. | Abelha FJ, Luís C, Veiga D, Parente D, Fernandes V, Santos P, Botelho M, Santos A, Santos C | Critical care (London, England) | 2013 | |
| Preoperative cerebrospinal fluid cytokine levels and the risk of postoperative delirium in elderly hip fracture patients. | Westhoff D, Witlox J, Koenderman L, Kalisvaart KJ, de Jonghe JF, van Stijn MF, Houdijk AP, Hoogland IC, Maclullich AM, van Westerloo DJ, van de Beek D, Eikelenboom P, van Gool WA | Journal of neuroinflammation | 2013 |
Aged, Aged, 80 and over, Biological Markers, cerebrospinal fluid, Cytokines, cerebrospinal fluid, Delirium, cerebrospinal fluid, Double-Blind Method, Female, Hip Fractures, cerebrospinal fluid, Humans, Male, Postoperative Complications, cerebrospinal fluid, Randomized Controlled Trials as Topic, Risk Factors |
| Delirium in Australian hospitals: a prospective study. | Travers C, Byrne GJ, Pachana NA, Klein K, Gray L | Current gerontology and geriatrics research | 2013 | |
| Confusion assessment method: a systematic review and meta-analysis of diagnostic accuracy. | Shi Q, Warren L, Saposnik G, Macdermid JC | Neuropsychiatric disease and treatment | 2013 | |
| Long-term cognitive impairment after critical illness. | Pandharipande PP, Girard TD, Jackson JC, Morandi A, Thompson JL, Pun BT, Brummel NE, Hughes CG, Vasilevskis EE, Shintani AK, Moons KG, Geevarghese SK, Canonico A, Hopkins RO, Bernard GR, Dittus RS, Ely EW, | The New England journal of medicine | 2013 |
Aged, Cognition Disorders, etiology, Critical Illness, psychology, Delirium, complications, Executive Function, Female, Humans, Intensive Care Units, Linear Models, Male, Middle Aged, Prospective Studies, Respiratory Insufficiency, complications, Shock, complications |
| Incidence and risk factors of early delirium after cardiac surgery. | Norkienė I, Ringaitienė D, Kuzminskaitė V, Šipylaitė J | BioMed research international | 2013 |
Aged, Cardiac Surgical Procedures, adverse effects, Delirium, epidemiology, Female, Humans, Intensive Care Units, Length of Stay, Male, Middle Aged, Postoperative Complications, epidemiology, Respiration, Artificial, adverse effects, Risk Factors |
| Intracerebral hemorrhage and delirium symptoms. Length of stay, function, and quality of life in a 114-patient cohort. | Naidech AM, Beaumont JL, Rosenberg NF, Maas MB, Kosteva AR, Ault ML, Cella D, Ely EW | American journal of respiratory and critical care medicine | 2013 |
Aged, Cerebral Hemorrhage, complications, Delirium, diagnosis, Female, Humans, Intensive Care Units, standards, Internet, Kaplan-Meier Estimate, Length of Stay, Logistic Models, Male, Middle Aged, Outcome Assessment (Health Care), Prognosis, Proportional Hazards Models, Prospective Studies, Quality of Life, Questionnaires, Sickness Impact Profile |
| High serum interleukin-6 level is associated with increased risk of delirium in elderly patients after noncardiac surgery: a prospective cohort study. | Liu P, Li YW, Wang XS, Zou X, Zhang DZ, Wang DX, Li SZ | Chinese medical journal | 2013 |
Aged, Cohort Studies, Delirium, etiology, Female, Humans, Interleukin-6, blood, Male, Middle Aged, Postoperative Complications, blood, Prospective Studies, Risk |
| Contextual issues influencing implementation and outcomes associated with an integrated approach to managing pain, agitation, and delirium in adult ICUs. | Carrothers KM, Barr J, Spurlock B, Ridgely MS, Damberg CL, Ely EW | Critical care medicine | 2013 |
Delirium, prevention & control, Delivery of Health Care, Integrated, organization & administration, Early Ambulation, Health Care Surveys, Hospitals, Community, Humans, Intensive Care, organization & administration, Intensive Care Units, Interdisciplinary Communication, Outcome Assessment (Health Care), Pain Management, Pilot Projects, Practice Guidelines as Topic, Program Development, Psychomotor Agitation, prevention & control, San Francisco, Ventilator Weaning |
| Who is at risk of long hospital stay among patients admitted to geriatric acute care unit? Results from a prospective cohort study. | Beauchet O, Launay C, de Decker L, Fantino B, Kabeshova A, Annweiler C | The journal of nutrition, health & aging | 2013 |
Aged, Aged, 80 and over, Critical Care, Delirium, complications, Female, France, Geriatrics, Hospital Units, Humans, Kaplan-Meier Estimate, Length of Stay, Linear Models, Male, Odds Ratio, Prospective Studies, Risk Factors, Sex Factors, Vitamin D Deficiency, blood |
| Implementing the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle into everyday care: opportunities, challenges, and lessons learned for implementing the ICU Pain, Agitation, and Delirium Guidelines. | Balas MC, Burke WJ, Gannon D, Cohen MZ, Colburn L, Bevil C, Franz D, Olsen KM, Ely EW, Vasilevskis EE | Critical care medicine | 2013 |
Academic Medical Centers, Delirium, prevention & control, Early Ambulation, methods, Evidence-Based Medicine, Focus Groups, Health Care Surveys, Health Knowledge, Attitudes, Practice, Humans, Intensive Care, methods, Intensive Care Units, Interdisciplinary Communication, Midwestern United States, Monitoring, Physiologic, methods, Practice Guidelines as Topic, Program Development, Prospective Studies, Psychomotor Agitation, prevention & control, Respiration, Artificial, Ventilator Weaning |
| Relationship between cognitive and non-cognitive symptoms of delirium. | Rajlakshmi AK, Mattoo SK, Grover S | Asian journal of psychiatry | 2013 |
Adult, Aged, Aged, 80 and over, Attention, physiology, Cognition Disorders, epidemiology, Comprehension, physiology, Cross-Sectional Studies, Delirium, epidemiology, Female, Humans, Male, Middle Aged, Motor Activity, physiology, Neuropsychological Tests, Prospective Studies, Psychiatric Status Rating Scales, Severity of Illness Index, Young Adult |
| Validation of the Swedish version of the Nursing Delirium Screening Scale used in patients 70 years and older undergoing cardiac surgery. | Lingehall HC, Smulter N, Engström KG, Gustafson Y, Olofsson B | Journal of clinical nursing | 2013 |
Aged, Aged, 80 and over, Delirium, diagnosis, Female, Humans, Male, Nursing Assessment, Sweden, Thoracic Surgery |
| Perioperative psycho-educational intervention can reduce postoperative delirium in patients after cardiac surgery: a pilot study. | Lee J, Jung J, Noh JS, Yoo S, Hong YS | International journal of psychiatry in medicine | 2013 |
Adult, Aged, Cross-Sectional Studies, Delirium, epidemiology, Empathy, Female, Heart Diseases, psychology, Humans, Intensive Care Units, Internship and Residency, Male, Middle Aged, Patient Education as Topic, methods, Perioperative Care, Physician-Patient Relations, Postoperative Complications, epidemiology, Retrospective Studies, Thoracic Surgery, education, Treatment Outcome |
| Effectiveness of a multi-component intervention to reduce delirium incidence in elderly care wards. | Holt R, Young J, Heseltine D | Age and ageing | 2013 |
Activities of Daily Living, Age Factors, Aged, Aged, 80 and over, Aging, Delirium, diagnosis, Emergencies, England, epidemiology, Female, Geriatric Assessment, Geriatrics, Hospital Mortality, Hospital Units, Hospitals, General, Humans, Incidence, Length of Stay, Male, Patient Admission, Patient Discharge, Predictive Value of Tests, Prognosis, Psychiatric Status Rating Scales, Risk Factors, Severity of Illness Index, Time Factors |
| White-matter hyperintensities predict delirium after cardiac surgery. | Hatano Y, Narumoto J, Shibata K, Matsuoka T, Taniguchi S, Hata Y, Yamada K, Yaku H, Fukui K | The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry | 2013 | |
| Developing and implementing an integrated delirium prevention system of care: a theory driven, participatory research study. | Godfrey M, Smith J, Green J, Cheater F, Inouye SK, Young JB | BMC health services research | 2013 |
Aged, Community-Based Participatory Research, methods, Delirium, prevention & control, Delivery of Health Care, Integrated, organization & administration, Education, England, Focus Groups, Health Knowledge, Attitudes, Practice, Humans, Interviews as Topic, Models, Organizational, Program Development, State Medicine, organization & administration |
| ICU early mobilization: from recommendation to implementation at three medical centers. | Engel HJ, Needham DM, Morris PE, Gropper MA | Critical care medicine | 2013 |
Academic Medical Centers, Baltimore, Early Ambulation, standards, Humans, Intensive Care, methods, Intensive Care Units, North Carolina, Program Development, Quality Improvement, Retrospective Studies, San Francisco |
| A greater analgesia, sedation, delirium order set quality score is associated with a decreased duration of mechanical ventilation in cardiovascular surgery patients. | Dale CR, Bryson CL, Fan VS, Maynard C, Yanez ND, Treggiari MM | Critical care medicine | 2013 |
Aged, Analgesia, methods, Cardiovascular Surgical Procedures, Clinical Protocols, Critical Illness, Delirium, diagnosis, Female, Humans, Hypnotics and Sedatives, administration & dosage, Intensive Care Units, Male, Middle Aged, Pain, diagnosis, Quality Indicators, Health Care, Quality of Health Care, organization & administration, Respiration, Artificial, methods, Retrospective Studies |
| Onset, risk factors, and impact of delirium in patients with traumatic spinal cord injury. | Cheung A, Thorogood NP, Noonan VK, Zhong Y, Fisher CG, Dvorak MF, Street J | Journal of neurotrauma | 2013 |
Aged, Cohort Studies, Delirium, epidemiology, Female, Humans, Length of Stay, Logistic Models, Male, Middle Aged, Retrospective Studies, Risk Factors, Spinal Cord Injuries, complications |
| The pain, agitation, and delirium care bundle: synergistic benefits of implementing the 2013 Pain, Agitation, and Delirium Guidelines in an integrated and interdisciplinary fashion. | Barr J, Pandharipande PP | Critical care medicine | 2013 |
Adult, Critical Illness, Delirium, drug therapy, Delivery of Health Care, Integrated, Humans, Intensive Care, methods, Intensive Care Units, Interdisciplinary Communication, Outcome Assessment (Health Care), Pain Management, Practice Guidelines as Topic, Psychomotor Agitation, drug therapy |
| Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the Intensive Care Unit: executive summary. | Barr J, Fraser GL, Puntillo K, Ely EW, Gélinas C, Dasta JF, Davidson JE, Devlin JW, Kress JP, Joffe AM, Coursin DB, Herr DL, Tung A, Robinson BR, Fontaine DK, Ramsay MA, Riker RR, Sessler CN, Pun B, Skrobik Y, Jaeschke R, | American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists | 2013 |
Adult, Delirium, diagnosis, Disease Management, Humans, Intensive Care Units, standards, Pain, diagnosis, Pain Management, methods, Psychomotor Agitation, diagnosis |
| Perceptions of nurses and physicians of their communication at night about intensive care patients' pain, agitation, and delirium. | Al-Qadheeb NS, Hoffmeister J, Roberts R, Shanahan K, Garpestad E, Devlin JW | American journal of critical care : an official publication, American Association of Critical-Care Nurses | 2013 |
Academic Medical Centers, Analysis of Variance, Communication, Data Collection, Delirium, Factor Analysis, Statistical, Female, Humans, Hypnotics and Sedatives, administration & dosage, Intensive Care Units, organization & administration, Male, Night Care, organization & administration, Pain, Physician-Nurse Relations, Psychomotor Agitation |
| Delirium in the acute phase after stroke and the role of the apolipoprotein E gene. | Oldenbeuving AW, de Kort PL, Kappelle LJ, van Duijn CM, Roks G | The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry | 2013 | |
| Consensus and variations in opinions on delirium care: a survey of European delirium specialists. | Morandi A, Davis D, Taylor JK, Bellelli G, Olofsson B, Kreisel S, Teodorczuk A, Kamholz B, Hasemann W, Young J, Agar M, de Rooij SE, Meagher D, Trabucchi M, MacLullich AM | International psychogeriatrics / IPA | 2013 |
Data Collection, Delirium, therapy, Europe, epidemiology, Geriatric Psychiatry, methods, Humans, Practice Guidelines as Topic, standards, Questionnaires |
| Effect of sedation level on the prevalence of delirium when assessed with CAM-ICU and ICDSC. | Haenggi M, Blum S, Brechbuehl R, Brunello A, Jakob SM, Takala J | Intensive care medicine | 2013 |
Aged, Consciousness, drug effects, Delirium, diagnosis, Female, Humans, Hypnotics and Sedatives, administration & dosage, Intensive Care, methods, Intensive Care Units, Male, Mass Screening, methods, Middle Aged, Prevalence, Psychiatric Status Rating Scales |
| Delirium outcomes in a randomized trial of blood transfusion thresholds in hospitalized older adults with hip fracture. | Gruber-Baldini AL, Marcantonio E, Orwig D, Magaziner J, Terrin M, Barr E, Brown JP, Paris B, Zagorin A, Roffey DM, Zakriya K, Blute MR, Hebel JR, Carson JL | Journal of the American Geriatrics Society | 2013 |
Aged, Aged, 80 and over, Blood Transfusion, methods, Delirium, blood, Erythrocyte Transfusion, methods, Female, Hemoglobinometry, Hip Fractures, blood, Hospitalization, Humans, Male, Mental Status Schedule, Neuropsychological Tests, Risk Factors |
| A pilot study to test the feasibility of a nonpharmacologic intervention for the prevention of delirium in the medical intensive care unit. | Foster J, Kelly M | Clinical nurse specialist CNS | 2013 |
Delirium, prevention & control, Feasibility Studies, Female, Humans, Intensive Care Units, Male, Pilot Projects, Prospective Studies, Southwestern United States |
| Delirium superimposed on dementia is associated with prolonged length of stay and poor outcomes in hospitalized older adults. | Fick DM, Steis MR, Waller JL, Inouye SK | Journal of hospital medicine : an official publication of the Society of Hospital Medicine | 2013 |
Aged, Aged, 80 and over, Cohort Studies, Delirium, diagnosis, Dementia, diagnosis, Female, Follow-Up Studies, Hospitalization, trends, Humans, Length of Stay, trends, Male, Prospective Studies, Risk Factors, Treatment Outcome |
| The AWOL tool: derivation and validation of a delirium prediction rule. | Douglas VC, Hessler CS, Dhaliwal G, Betjemann JP, Fukuda KA, Alameddine LR, Lucatorto R, Johnston SC, Josephson SA | Journal of hospital medicine : an official publication of the Society of Hospital Medicine | 2013 |
Aged, Aged, 80 and over, Cohort Studies, Delirium, diagnosis, Female, Follow-Up Studies, Humans, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Psychiatric Status Rating Scales, standards, Risk Factors |
| The epidemiology of delirium: challenges and opportunities for population studies. | Davis DH, Kreisel SH, Muniz Terrera G, Hall AJ, Morandi A, Boustani M, Neufeld KJ, Lee HB, Maclullich AM, Brayne C | The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry | 2013 |
Cognition Disorders, epidemiology, Data Collection, methods, Delirium, diagnosis, Disease Progression, Humans, Research Design |
| Delirium during acute illness in nursing home residents. | Boockvar K, Signor D, Ramaswamy R, Hung W | Journal of the American Medical Directors Association | 2013 |
Acute Disease, Aged, Cognition Disorders, epidemiology, Delirium, epidemiology, Female, Geriatric Assessment, Humans, Incidence, Male, New York City, epidemiology, Nursing Homes, Prospective Studies, Risk Factors |
| Antipsychotic prescribing patterns, and the factors and outcomes associated with their use, among patients requiring prolonged mechanical ventilation in the long-term acute care hospital setting. | Al-Qadheeb NS, O'Connor HH, White AC, Neidhardt A, Albizati M, Joseph B, Roberts RJ, Ruthazer RR, Devlin JW | The Annals of pharmacotherapy | 2013 |
Adult, Aged, Aged, 80 and over, Antipsychotic Agents, administration & dosage, Benzodiazepines, administration & dosage, Caregivers, Cohort Studies, Delirium, diagnosis, Dibenzothiazepines, administration & dosage, Drug Administration Schedule, Female, Hospitals, Chronic Disease, Humans, Male, Massachusetts, Medical Records, Middle Aged, Patient Participation, Physician’s Practice Patterns, Psychiatric Status Rating Scales, Respiration, Artificial, psychology, Retrospective Studies |
| Pre-existing cerebral infarcts as a risk factor for delirium after coronary artery bypass graft surgery. | Otomo S, Maekawa K, Goto T, Baba T, Yoshitake A | Interactive cardiovascular and thoracic surgery | 2013 |
Aortic Diseases, complications, Atherosclerosis, complications, Cerebral Angiography, Cerebral Infarction, complications, Cognition, Cognition Disorders, complications, Coronary Artery Bypass, adverse effects, Delirium, diagnosis, Female, Humans, Magnetic Resonance Angiography, Male, Middle Aged, Neuropsychological Tests, Prospective Studies, Risk Factors, Surgical Procedures, Elective, Ultrasonography, Interventional |
| Delirium after cardiac surgery: incidence and risk factors. | Smulter N, Lingehall HC, Gustafson Y, Olofsson B, Engström KG | Interactive cardiovascular and thoracic surgery | 2013 |
Age Factors, Aged, Aged, 80 and over, Cardiac Surgical Procedures, adverse effects, Delirium, diagnosis, Female, Humans, Incidence, Logistic Models, Male, Multivariate Analysis, Odds Ratio, Psychiatric Status Rating Scales, Risk Factors, Sweden, epidemiology |
| Predictive factors for agitation severity of hyperactive delirium in terminally ill cancer patients in a general hospital using ordered logistic regression analysis. | Kanbayashi Y, Hatano Y, Hata Y, Morita T, Fukui K, Hosokawa T | Journal of palliative medicine | 2013 |
Aged, Anti-Bacterial Agents, therapeutic use, Anti-Inflammatory Agents, Non-Steroidal, therapeutic use, Bilirubin, analysis, Delirium, epidemiology, Female, Hematologic Neoplasms, complications, Hospitals, General, Humans, Japan, epidemiology, Logistic Models, Male, Middle Aged, Predictive Value of Tests, Prevalence, Psychomotor Agitation, epidemiology, Risk Factors, Severity of Illness Index, Sex Factors, Terminally Ill |
| Outcomes of a Geriatric Liaison Intervention to Prevent the Development of Postoperative Delirium in Frail Elderly Cancer Patients: Report on a Multicentre, Randomized, Controlled Trial. | Hempenius L, Slaets JP, van Asselt D, de Bock GH, Wiggers T, van Leeuwen BL | PloS one | 2013 | |
| Care in specialist medical and mental health unit compared with standard care for older people with cognitive impairment admitted to general hospital: randomised controlled trial (NIHR TEAM trial). | Goldberg SE, Bradshaw LE, Kearney FC, Russell C, Whittamore KH, Foster PE, Mamza J, Gladman JR, Jones RG, Lewis SA, Porock D, Harwood RH, | BMJ (Clinical research ed.) | 2013 |
Aged, Aged, 80 and over, Cognition Disorders, therapy, Delirium, therapy, Dementia, therapy, Female, Great Britain, Hospitalization, Hospitals, General, Humans, Length of Stay, Male, Neuropsychological Tests, Outcome Assessment (Health Care), Patient Readmission, Psychiatric Department, Hospital, Quality of Health Care, Quality of Life |
| At the extreme end of the psychoneuroimmunological spectrum: delirium as a maladaptive sickness behaviour response. | Cunningham C, Maclullich AM | Brain, behavior, and immunity | 2013 |
Adaptation, Physiological, physiology, Animals, Anxiety, complications, Brain, physiopathology, Cognition, physiology, Delirium, etiology, Depression, complications, Humans, Illness Behavior, physiology, Inflammation, complications, Neurodegenerative Diseases, complications, Stress, Physiological, physiology |
| The stress response to surgery and postoperative delirium: evidence of hypothalamic-pituitary-adrenal axis hyperresponsiveness and decreased suppression of the GH/IGF-1 Axis. | Cerejeira J, Batista P, Nogueira V, Vaz-Serra A, Mukaetova-Ladinska EB | Journal of geriatric psychiatry and neurology | 2013 |
Aged, Aged, 80 and over, Anesthesia, Arthroplasty, Replacement, Hip, adverse effects, Cognition, physiology, Data Interpretation, Statistical, Delirium, etiology, Female, Growth Hormone, blood, Humans, Hydrocortisone, blood, Hypothalamo-Hypophyseal System, physiopathology, Immune System, physiology, Inflammation Mediators, blood, Insulin-Like Growth Factor I, physiology, Male, Middle Aged, Neurosecretory Systems, physiology, Perioperative Care, Pituitary-Adrenal System, physiopathology, Postoperative Complications, etiology, Postoperative Period, Stress, Physiological, physiology |
| Do earplugs and eye masks affect sleep and delirium outcomes in the critically ill? | Alway A, Halm MA, Shilhanek M, St Pierre J | American journal of critical care : an official publication, American Association of Critical-Care Nurses | 2013 |
Critical Illness, Delirium, prevention & control, Ear Protective Devices, Humans, Intensive Care Units, Masks, Self Report, Sleep Disorders, prevention & control |
| Outcomes of early delirium diagnosis after general anesthesia in the elderly. | Neufeld KJ, Leoutsakos JM, Sieber FE, Wanamaker BL, Gibson Chambers JJ, Rao V, Schretlen DJ, Needham DM | Anesthesia and analgesia | 2013 |
Activities of Daily Living, Aftercare, Age Factors, Aged, Aged, 80 and over, Anesthesia Recovery Period, Anesthesia, General, adverse effects, Baltimore, epidemiology, Cognition, Cognition Disorders, diagnosis, Delirium, diagnosis, Early Diagnosis, Female, Humans, Institutionalization, Linear Models, Logistic Models, Male, Multivariate Analysis, Neuropsychological Tests, Patient Discharge, Patient Transfer, Predictive Value of Tests, Prevalence, Prognosis, Prospective Studies, Psychiatric Status Rating Scales, Recovery Room, Risk Factors, Time Factors |
| An enhanced exercise and cognitive programme does not appear to reduce incident delirium in hospitalised patients: a randomised controlled trial. | Jeffs KJ, Berlowitz DJ, Grant S, Lawlor V, Graco M, de Morton NA, Savige JA, Lim WK | BMJ open | 2013 | |
| BIS-guided anesthesia decreases postoperative delirium and cognitive decline. | Chan MT, Cheng BC, Lee TM, Gin T, | Journal of neurosurgical anesthesiology | 2013 |
Aged, Anesthesia, General, adverse effects, Asian Continental Ancestry Group, Cognition Disorders, etiology, Color Perception, physiology, Consciousness Monitors, Delirium, etiology, Female, Humans, Male, Neuropsychological Tests, Postoperative Complications, prevention & control, Prospective Studies, Risk Factors, Treatment Outcome, Verbal Behavior, Verbal Learning |
| Investigating polypharmacy and drug burden index in hospitalised older people. | Best O, Gnjidic D, Hilmer SN, Naganathan V, McLachlan AJ | Internal medicine journal | 2013 |
Age Factors, Aged, Aged, 80 and over, Cholinergic Antagonists, administration & dosage, Cohort Studies, Delirium, chemically induced, Female, Hospitalization, trends, Humans, Hypnotics and Sedatives, administration & dosage, Male, New South Wales, epidemiology, Polypharmacy, Retrospective Studies |
| An analytical framework for delirium research in palliative care settings: integrated epidemiologic, clinician-researcher, and knowledge user perspectives. | Lawlor PG, Davis DH, Ansari M, Hosie A, Kanji S, Momoli F, Bush SH, Watanabe S, Currow DC, Gagnon B, Agar M, Bruera E, Meagher DJ, de Rooij SE, Adamis D, Caraceni A, Marchington K, Stewart DJ | Journal of pain and symptom management | 2014 | |
| Practical assessment of delirium in palliative care. | Leonard MM, Nekolaichuk C, Meagher DJ, Barnes C, Gaudreau JD, Watanabe S, Agar M, Bush SH, Lawlor PG | Journal of pain and symptom management | 2014 | |
| Delirium diagnostic and classification challenges in palliative care: subsyndromal delirium, comorbid delirium-dementia, and psychomotor subtypes. | Leonard MM, Agar M, Spiller JA, Davis B, Mohamad MM, Meagher DJ, Lawlor PG | Journal of pain and symptom management | 2014 | |
| End-of-life delirium: issues regarding recognition, optimal management, and the role of sedation in the dying phase. | Bush SH, Leonard MM, Agar M, Spiller JA, Hosie A, Wright DK, Meagher DJ, Currow DC, Bruera E, Lawlor PG | Journal of pain and symptom management | 2014 | |
| A comparison of the revised Delirium Rating Scale (DRS-R98) and the Memorial Delirium Assessment Scale (MDAS) in a palliative care cohort with DSM-IV delirium. | O'Sullivan R, Meagher D, Leonard M, Watne LO, Hall RJ, Maclullich AM, Trzepacz P, Adamis D | Palliative & supportive care | 2015 | |
| 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). | Davis DH, Barnes LE, Stephan BC, MacLullich AM, Meagher D, Copeland J, Matthews FE, Brayne C, | BMC geriatrics | 2014 | |
| Phenomenological and biological correlates of improved cognitive function in hospitalized elderly medical inpatients. | Adamis D, Meagher D, Treloar A, Dunne C, Larvin M, Martin FC, Macdonald AJ | Archives of gerontology and geriatrics | 2014 | |
| Delirium during psychiatric admission increases mortality in psychiatric patients during and after hospitalization. A nationwide study from 1995 through 2012. | Lundberg AS, Gustafsson LN, Meagher D, Munk-Jørgensen P | Journal of psychosomatic research | 2014 | |
| The CareWell in Hospital program to improve the quality of care for frail elderly inpatients: results of a before-after study with focus on surgical patients. | Bakker FC, Persoon A, Bredie SJ, van Haren-Willems J, Leferink VJ, Noyez L, Schoon Y, Olde Rikkert MG | American journal of surgery | 2014 | |
| Outcomes of an innovative model of acute delirium care: the Geriatric Monitoring Unit (GMU). | Chong MS, Chan M, Tay L, Ding YY | Clinical interventions in aging | 2014 | |
| Delirium in elderly people--authors'reply. | Inouye SK, Westendorp RG, Saczynski JS, Kimchi EY, Cleinman AA | Lancet | 2014 |
Delirium, diagnosis, Humans |
| Delirium risk prediction, healthcare use and mortality of elderly adults in the emergency department. | Kennedy M, Enander RA, Tadiri SP, Wolfe RE, Shapiro NI, Marcantonio ER | Journal of the American Geriatrics Society | 2014 |
Aged, Aged, 80 and over, Delirium, complications, Delivery of Health Care, utilization, Emergency Service, Hospital, Female, Follow-Up Studies, Geriatric Assessment, methods, Humans, Incidence, Length of Stay, trends, Male, Massachusetts, epidemiology, Mental Status Schedule, Prospective Studies, Risk Factors, Stroke, complications, Survival Rate, trends |
| Preoperative cerebrospinal fluid β-Amyloid/Tau ratio and postoperative delirium. | Xie Z, Swain CA, Ward SA, Zheng H, Dong Y, Sunder N, Burke DW, Escobar D, Zhang Y, Marcantonio ER | Annals of clinical and translational neurology | 2014 | |
| Calibration and validation of an innovative approach for estimating general cognitive performance. | Gross AL, Jones RN, Fong TG, Tommet D, Inouye SK | Neuroepidemiology | 2014 | |
| The modified Hospital Elder Life Program: adapting a complex intervention for feasibility and scalability in a surgical setting. | Chen CC, Saczynski J, Inouye SK | Journal of gerontological nursing | 2014 |
Aged, Evidence-Based Practice, Feasibility Studies, Health Services for the Aged, organization & administration, Hospitals, Humans, Surgical Procedures, Operative |
| NICE to HELP: operationalizing National Institute for Health and Clinical Excellence guidelines to improve clinical practice. | Yue J, Tabloski P, Dowal SL, Puelle MR, Nandan R, Inouye SK | Journal of the American Geriatrics Society | 2014 |
Aged, 80 and over, Delirium, diagnosis, Delivery of Health Care, standards, Geriatrics, standards, Great Britain, epidemiology, Humans, Practice Guidelines as Topic, Prevalence |
| Delirium diagnosis methodology used in research: a survey-based study. | Neufeld KJ, Nelliot A, Inouye SK, Ely EW, Bienvenu OJ, Lee HB, Needham DM | The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry | 2014 | |
| Systemic inflammation impairs attention and cognitive flexibility but not associative learning in aged rats: possible implications for delirium. | Culley DJ, Snayd M, Baxter MG, Xie Z, Lee IH, Rudolph J, Inouye SK, Marcantonio ER, Crosby G | Frontiers in aging neuroscience | 2014 | |
| The Prevention of Delirium and Complications Associated with Surgical Treatments (PODCAST) study: protocol for an international multicentre randomised controlled trial. | Avidan MS, Fritz BA, Maybrier HR, Muench MR, Escallier KE, Chen Y, Ben Abdallah A, Veselis RA, Hudetz JA, Pagel PS, Noh G, Pryor K, Kaiser H, Arya VK, Pong R, Jacobsohn E, Grocott HP, Choi S, Downey RJ, Inouye SK, Mashour GA | BMJ open | 2014 | |
| Effectiveness and safety of the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle. | Balas MC, Vasilevskis EE, Olsen KM, Schmid KK, Shostrom V, Cohen MZ, Peitz G, Gannon DE, Sisson J, Sullivan J, Stothert JC, Lazure J, Nuss SL, Jawa RS, Freihaut F, Ely EW, Burke WJ | Critical care medicine | 2014 |
Adult, Aged, Clinical Protocols, Cohort Studies, Delirium, therapy, Exercise, Female, Humans, Hypnotics and Sedatives, therapeutic use, Immobilization, adverse effects, Intensive Care, methods, Male, Middle Aged, Prospective Studies, Regression Analysis, Respiration, Artificial, adverse effects, Treatment Outcome, Ventilator Weaning, methods |
| Comparison of symptoms of delirium across various motoric subtypes. | Grover S, Sharma A, Aggarwal M, Mattoo SK, Chakrabarti S, Malhotra S, Avasthi A, Kulhara P, Basu D | Psychiatry and clinical neurosciences | 2014 | |
| The efficacy of peri-operative interventions to decrease postoperative delirium in non-cardiac surgery: a systematic review and meta-analysis. | Moyce Z, Rodseth RN, Biccard BM | Anaesthesia | 2014 |
Delirium, prevention & control, Humans, Perioperative Care, methods, Postoperative Complications, prevention & control, Referral and Consultation |
| Interleukin 6 and apolipoprotein E as predictors of acute brain dysfunction and survival in critical care patients. | Alexander SA, Ren D, Gunn SR, Kochanek PM, Tate J, Ikonomovic M, Conley YP | American journal of critical care : an official publication, American Association of Critical-Care Nurses | 2014 | |
| Decreasing inappropriate unable-to-assess ratings for the confusion assessment method for the intensive care unit. | Swan JT | American journal of critical care : an official publication, American Association of Critical-Care Nurses | 2014 | |
| Anticholinergic activity in cerebrospinal fluid and serum in individuals with hip fracture with and without delirium. | Watne LO, Hall RJ, Molden E, Raeder J, Frihagen F, MacLullich AM, Juliebø V, Nyman A, Meagher D, Wyller TB | Journal of the American Geriatrics Society | 2014 |
APACHE, Activities of Daily Living, Aged, Aged, 80 and over, Cholinergic Antagonists, blood, Comorbidity, Delirium, diagnosis, Female, Hip Fractures, complications, Humans, Male, Middle Aged, Norway, Prospective Studies, Questionnaires, Scotland, Severity of Illness Index |
| Antipsychotics for delirium in the general hospital setting in consecutive 2453 inpatients: a prospective observational study. | Hatta K, Kishi Y, Wada K, Odawara T, Takeuchi T, Shiganami T, Tsuchida K, Oshima Y, Uchimura N, Akaho R, Watanabe A, Taira T, Nishimura K, Hashimoto N, Usui C, Nakamura H | International journal of geriatric psychiatry | 2014 | |
| The CAM-S: development and validation of a new scoring system for delirium severity in 2 cohorts. | Inouye SK, Kosar CM, Tommet D, Schmitt EM, Puelle MR, Saczynski JS, Marcantonio ER, Jones RN | Annals of internal medicine | 2014 |
Activities of Daily Living, Aged, Aged, 80 and over, Cognition Disorders, diagnosis, Delirium, diagnosis, Female, Hospital Costs, Humans, Length of Stay, Male, Nursing Homes, Psychological Tests, Psychometrics, Severity of Illness Index |
| A tale of two methods: chart and interview methods for identifying delirium. | Saczynski JS, Kosar CM, Xu G, Puelle MR, Schmitt E, Jones RN, Marcantonio ER, Wong B, Isaza I, Inouye SK | Journal of the American Geriatrics Society | 2014 |
Aged, Aged, 80 and over, Cohort Studies, Delirium, diagnosis, Female, Humans, Interview, Psychological, methods, Male, Medical Records, Prospective Studies, Psychological Tests, Reproducibility of Results, Severity of Illness Index |
| Effect of leaflet-based intervention on family members of terminally ill patients with cancer having delirium: historical control study. | Otani H, Morita T, Uno S, Yamamoto R, Hirose H, Matsubara T, Takigawa C, Sasaki K | The American journal of hospice & palliative care | 2014 | |
| Preparation to care for confused older patients in general hospitals: a study of UK health professionals. | Griffiths A, Knight A, Harwood R, Gladman JR | Age and ageing | 2014 | |
| Prediction of delirium in critically ill patients with elevated C-reactive protein. | Zhang Z, Pan L, Deng H, Ni H, Xu X | Journal of critical care | 2014 | |
| Barriers and facilitators to implementing delirium rounds in a clinical trial across three diverse hospital settings. | Yevchak AM, Fick DM, McDowell J, Monroe T, May K, Grove L, Kolanowski AM, Waller JL, Inouye SK | Clinical nursing research | 2014 | |
| Feasibility and acceptability of a delirium prevention program for cognitively impaired long term care residents: a participatory approach. | Voyer P, McCusker J, Cole MG, Monette J, Champoux N, Vu M, Ciampi A, Sanche S, Richard S, de Raad M | Journal of the American Medical Directors Association | 2014 | |
| Safety incidents involving confused and forgetful older patients in a specialised care setting - analysis of the safety incidents reported to the HaiPro reporting system. | Kinnunen-Luovi K, Saarnio R, Isola A | Journal of clinical nursing | 2014 | |
| Prognosis of delirium in hospitalized elderly: worse than we thought. | Dasgupta M, Brymer C | International journal of geriatric psychiatry | 2014 | |
| Delirium in the ICU and subsequent long-term disability among survivors of mechanical ventilation. | Brummel NE, Jackson JC, Pandharipande PP, Thompson JL, Shintani AK, Dittus RS, Gill TM, Bernard GR, Ely EW, Girard TD | Critical care medicine | 2014 |
Activities of Daily Living, Aged, Delirium, complications, Female, Humans, Intensive Care Units, Male, Middle Aged, Prospective Studies, Questionnaires, Respiration, Artificial, Survivors, Time Factors |
| Validation and psychometric properties of the Delirium Motor Subtype Scale in elderly hip fracture patients (Dutch version). | Slor CJ, Adamis D, Jansen RW, Meagher DJ, Witlox J, Houdijk AP, de Jonghe JF | Archives of gerontology and geriatrics | 2014 |
Aged, Aged, 80 and over, Delirium, classification, Female, Fracture Fixation, Hip Fractures, complications, Humans, Male, Motor Activity, Netherlands, Psychiatric Status Rating Scales, ROC Curve, Reproducibility of Results, Severity of Illness Index |
| Delirium is a predictor of in-hospital mortality in elderly patients with community acquired pneumonia. | Pieralli F, Vannucchi V, Mancini A, Grazzini M, Paolacci G, Morettini A, Nozzoli C | Internal and emergency medicine | 2014 | |
| Delirium in elderly people. | Inouye SK, Westendorp RG, Saczynski JS | Lancet | 2014 |
Aged, Biomedical Research, methods, Cognition Disorders, etiology, Delirium, diagnosis, Dementia, etiology, Humans, Prognosis, Risk Factors |
| Delirium in adult patients receiving palliative care: a systematic review of the literature. | Sánchez-Román S, Beltrán Zavala C, Lara Solares A, Chiquete E | Revista de psiquiatrí́a y salud mental | 2014 | |
| Is delirium an unrecognized threat to patient safety in Korean intensive care units? | Moon KJ, Piao J, Jin Y, Lee SM | Journal of nursing care quality | 2014 | |
| The impact of soluble interleukin-2 receptor as a biomarker of delirium. | Baranyi A, Rothenhäusler HB | Psychosomatics | 2014 | |
| Pharmacologic risk factors for post-operative delirium in total joint arthroplasty patients: a case-control study. | Nandi S, Harvey WF, Saillant J, Kazakin A, Talmo C, Bono J | The Journal of arthroplasty | 2014 |
Aged, Analgesics, Opioid, adverse effects, Anesthetics, adverse effects, Arthroplasty, Replacement, Hip, adverse effects, Arthroplasty, Replacement, Knee, adverse effects, Benzodiazepines, adverse effects, Case-Control Studies, Cognition Disorders, Delirium, chemically induced, Female, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors |