JAMDA
Volume 11, Issue 4 , Pages 253-256 , May 2010

Prevalence of Delirium on Admission to Postacute Care is Associated With a Higher Number of Nursing Home Deficiencies

  • Richard N. Jones, ScD

      Affiliations

    • Institute for Aging Research, Hebrew SeniorLife, Boston, MA
    • Beth Israel Deaconess Medical Center, Boston, MA
    • Harvard Medical School, Boston, MA
    • Corresponding Author InformationAddress correspondence to Richard N. Jones, ScD, Institute for Aging Research, Hebrew SeniorLife, 1200 Centre Street, Boston, MA 02131.
    • ,
  • Dan K. Kiely, MPH, MA

      Affiliations

    • Institute for Aging Research, Hebrew SeniorLife, Boston, MA
    • ,
  • Edward R. Marcantonio, MD, SM

      Affiliations

    • Institute for Aging Research, Hebrew SeniorLife, Boston, MA
    • Beth Israel Deaconess Medical Center, Boston, MA
    • Harvard Medical School, Boston, MA

References 

  1. Inouye SK. Delirium in older persons. N Engl J Med. 2006;354:1157–1165
  2. McCusker J, Cole M, Dendukuri N, et al. The course of delirium in older medical inpatients: a prospective study. J Gen Intern Med. 2003;18:696–704
  3. Medicare Payment Advisory Commission (MEDPAC). A Data Book: Healthcare Spending and the Medicare Program. Washington DC: MEDPAC; 2005;
  4. Marcantonio E, Simon S, Bergmann M, et al. Delirium symptoms in post-acute care: prevalent, persistent, and associated with poor functional recovery. J Am Geriatr Soc. 2003;51:4–9
  5. Inouye SK, Schlesinger MJ, Lydon TJ. Delirium: A symptom of how hospital care is failing older persons and a window to improve quality of hospital care. Am J Med. 1999;106:565–573
  6. Centers for Medicare and Medicaid Services. Nursing Home Compare. April 23, 2008. Available at: http://www.medicare.gov/NHCompare/Static/Reated/DataCollection.asp. Accessed July 25, 2008.
  7. In:  Wunderlich G,  Kohler P editor. Institute of Medicine (US) Committee on Improving Quality in Long-Term Care. Improving the Quality of Long-Term Care. Washington DC: National Academy Press; 2001;
  8. Bergmann MA, Murphy KM, Kiely DK, et al. A model for management of delirious postacute care patients. J Am Geriatr Soc. 2005;53:1817–1825
  9. Kiely D, Jones R, Bergman M, et al. Association between delirium resolution and functional recovery among newly admitted post-acute facility patients. J Gerontol A Biol Sci Med Sci. 2006;61A:204–208
  10. Marcantonio ER, Kiely DK, Simon SE, et al. Outcomes of elders admitted to post-acute facilities with delirium. J Am Geriatr Soc. 2005;53:963–969
  11. Kiely DK, Bergmann MA, Jones RN, et al. Characteristics associated with delirium persistence among newly admitted post-acute facility patients. J Gerontol A Biol Sci Med Sci. 2004;59:M344–M349
  12. Kiely DK, Bergmann MA, Murphy KM, et al. Delirium among newly admitted postacute facility patients: Prevalence, symptoms, and severity. J Gerontol A Biol Sci Med Sci. 2003;58:M441–M445
  13. Inouye SK, van Dyck CH, Alessi CA, et al. Clarifying confusion: The confusion assessment method. A new method for detection of delirium. Ann Intern Med. 1990;113:941–948
  14. Simon S, Bergmann M, Jones R, et al. Reliability of a structured assessment for non-clinicians to detect delirium among new admissions to post-acute care. J Am Med Dir Assoc. 2006;7:412–415
  15. Inouye SK. Delirium in hospitalized older patients: Recognition and risk factors. J Geriatr Psychiatry Neurol. 1998;11:118–125discussion 157–118
  16. Levinson DR. Trends in Nursing Home Deficiencies and Complaints. Washington, DC: Department of Health and Human Services, Office of the Inspector General; 2008;
  17. Blom G. Statistical Estimates and Transformed Beta Variables. New York: John Wiley & Sons, Inc; 1958;
  18. Muthén L, Muthén B. Mplus Users Guide. Version 5. Los Angeles, CA: Muthén & Muthén; 1998–2007;
  19. Marcantonio E, Murphy K, Jones R, et al. Improving detection of delirium among new admissions to post-acute facilities: A randomized controlled trial. J Am Geriatr Soc. 2005;53:S5
  20. Rockwood K. Need we do so badly in managing delirium in elderly patients?. Age Ageing. 2003;32:473–474
  21. Kiely D, Jones R, Bergman M, et al. The association between delirium resolution and functional recovery among newly admitted post-acute facility patients. J Gerontol A Biol Sci Med Sci. 2006;61A:204–208
  22. Inouye SK, Bogardus ST, Charpentier PA, et al. A multicomponent intervention to prevent delirium in hospitalized older patients. N Engl J Med. 1999;340:669–676
  23. Marcantonio ER, Flacker JM, Wright RJ, Resnick NM. Reducing delirium after hip fracture: A randomized trial. J Am Geriatr Soc. 2001;49:516–522

 The Trial to Reduce Delirium in Aged Post Acute Patients is registered at www.clinicaltrials.gov (NCT00182936) and is no longer accepting participants.

 Funded in part by grants from the National Institute on Aging, R01AG17649 and P60AG008812. E.R.M. is a Paul Beeson Physician Faculty Scholar in Aging Research. The research was completed independent of influence from the funding sources. All authors had full access to all of the data in the study. R.N.J. and E.R.M. take responsibility for the integrity of the data and the accuracy of the data analysis.

PII: S1525-8610(09)00294-1

doi: 10.1016/j.jamda.2009.08.009

JAMDA
Volume 11, Issue 4 , Pages 253-256 , May 2010

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