Contributed by Dr. Sophia Wang, MD, MS, Assistant Professor of Clinical Psychiatry, Indiana University School of Medicine Postoperative delirium affects 15-50% of older adults undergoing major surgery.1 The literature strongly supports a bidirectional relationship between delirium and dementia.2 While both delirium and dementia affect cognition, they are quite different in their clinical presentations. Delirium is […]
Category Archives: Delirium Research
Association between Symptom Domains of Delirium and Outcomes in Hospitalised Adults
Contributed by Zoë Tieges, PhD, Psychology Research Fellow, Geriatric Medicine, Usher Institute, The University of Edinburgh, Edinburgh, UK Research question: do patients with delirium experience poorer outcomes when they have certain symptoms? Delirium is a syndrome with a wide spectrum of clinical presentations. According to DSM-5 (and the recent DSM-5 Text Revision) criteria, the key […]
The Posterior Dominant Rhythm: A Proof-of-Principle Study Whether it is an Electroencephalographic Biomarker for Tracking Delirium Onset and Recovery
Contributed by Ben Julian A. Palanca, MD, PhD, MSc, Associate Professor of Anesthesiology, Associate Professor of Psychiatry, Washington University School of Medicine in St. Louis; Affiliated Faculty, Department of Biomedical Engineering, Washington University; Director, Sleepy Brain Lab Predictive biomarkers for prognosticating delirium onset and severity are needed for targeting interventions that may prevent delirium onset. […]
Selective Serotonin Reuptake Inhibitor (SSRI) Use and Delirium Occurrence in the ICU
Contributed by C. Adrian Austin, MD, MSCR, Divisions of Geriatric Medicine and Pulmonary Diseases and Critical Care Medicine, University of North Carolina School of Medicine, Chapel Hill, NC Anxiety, depression and ICU delirium may be linked.1 Approximately 10% of the U.S. population takes an antidepressant, most commonly a selective serotonin reuptake inhibitor (SSRI).2 It remains […]
A Conceptual Framework for Social Determinants of Health and Delirium (SDOH)
Franchesca Arias, PhD Assistant Professor, Department of Clinical and Health Psychology, University of Florida By 2050 it is expected that over 22% of the global population will be >60 years old.1 Late adulthood is a unique life stage2 associated with distinct cognitive vulnerabilities and medical needs. Of those ≥ 65 years old in the United […]
Clinical Outcomes Following Implementation of a Hospital-Wide, Multicomponent Delirium Care Pathway: A Before-After Quality Improvement Study
Sara LaHue, MD Assistant Professor of Clinical Neurology, University of California, San Francisco We cannot improve upon what we do not measure. While data suggests that more than 7 million adults in the United States develop delirium each year, this is likely an underestimate as delirium is poorly recognized without systematic screening.1 Delirium itself is […]
The Consequences of Unwarranted Pharmacologic Treatment of ICU Delirium
Christina Boncyk, MD, MPH Assistant Professor of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN The generally positive results of older controlled studies evaluating antipsychotics for intensive care unit (ICU) delirium treatment helped potentiate the routine use of these agents in critically ill adults despite the serious limitations of these studies.1-3 While more recent publications of […]
Using Limited Lead Rapid Response EEG to Detect Delirium: A Proof-of-Concept Study
Malissa Mulkey, PhD, APRN, CCNS, CCRN Post-Doctoral Research Fellow, Indiana University Medical Center, Indianapolis, IN Based on the Diagnostic and Statistical Manual for Mental Disorders-Version 5 (DSM-V) delirium is defined as encompassing a reduction in attention, impairment in both cognition and memory and awareness.1 Historically, due to the high prevalence in the intensive care setting, […]
Do more complex brain electrical signals protect against postoperative delirium?
Leah Acker, MD, PhD, Assistant Professor of Anesthesiology, Duke University Medical Center, Durham, NC Outside of the delirium field, less complex physiological output signals often are associated with increased risk of geriatric syndromes. For example, an increased risk of falls is associated with less complex musculoskeletal adjustment movements.1 Overall, less complex physiological signals are associated […]
Does Treating Incident ICU Delirium with Haloperidol Improve Outcomes?
Matthew S. Duprey, PharmD, PhD, BCCCP Investigator, Department of Health Services, Policy, and Practice, Brown University School of Public Health Practitioners familiar with delirium and its consequences have long sought a medication-based treatment to reduce its severity and duration in hospital and also improve post-hospitalization outcomes including long-term cognitive impairment. Despite three randomized controlled trials […]