Abstract
Objective
Sensory deficits are important risk factors for delirium but have been investigated
in single-center studies and single clinical settings. This multicenter study aims
to evaluate the association between hearing and visual impairment or bi-sensory impairment
(visual and hearing impairment) and delirium.
Design
Cross-sectional study nested in the 2017 “Delirium Day” project.
Setting and Participants
Patients 65 years and older admitted to acute hospital medical wards, emergency departments,
rehabilitation wards, nursing homes, and hospices in Italy.
Methods
Delirium was assessed with the 4AT (a short tool for delirium assessment) and sensory
deficits with a clinical evaluation. We assessed the association between delirium,
hearing and visual impairment in multivariable logistic regression models, adjusting
for: Model 1, we included predisposing factors for delirium (ie, dementia, weight
loss and autonomy in the activities of daily living); Model 2, we added to Model 1
variables, which could be considered precipitating factors for delirium (ie, psychoactive
drugs and urinary catheters).
Results
A total of 3038 patients were included; delirium prevalence was 25%. Patients with
delirium had a higher prevalence of hearing impairment (30.5% vs 18%; P < .001), visual impairment (24.2% vs 15.7%; P < .01) and bi-sensory impairment (16.2% vs 7.5%) compared with those without delirium.
In the multivariable logistic regression analysis, the presence of bi-sensory impairment
was associated with delirium in Model 1 [odds ratio (OR) 1.5, confidence interval
(CI) 1.2–2.1; P = .00] and in Model 2 (OR 1.4; CI 1.1–1.9; P = .02), whereas the presence of visual and hearing impairment alone was not associated
with delirium either in Model 1 (OR 0.8; CI 0.6–1.2, P = .36; OR 1.1; CI 0.8–1.4; P = .42) or in Model 2 (OR 0.8, CI 0.6–1.2, P = .27; OR 1.1, CI 0.8–1.4, P = .63).
Conclusions and implications
Our findings support the importance of routine screening and specific interventions
by a multidisciplinary team to implement optimal management of sensory impairments
and hence prevention and the management of the patients with delirium.
Keywords
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Article info
Publication history
Published online: November 04, 2020
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
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