Environmental Factors Predict the Severity of Delirium Symptoms in Long-Term Care Residents with and without Delirium
Article first published online: 21 MAR 2013
© 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 61, Issue 4, pages 502–511, April 2013
How to Cite
J Am Geriatr Soc 61:502–511, 2013.
- Issue published online: 14 APR 2013
- Article first published online: 21 MAR 2013
- Canadian Institutes of Health Research. Grant Number: IAO69519
- Canadian Institute of Aging and the Institute of Gender and Health. Grant Number: CRG-82953
- Alzheimer Society of Canada and the Canadian Nurses Foundation. Grant Number: 07–91
- long-term care;
- risk factors
To identify potentially modifiable environmental factors (including number of medications) associated with changes over time in the severity of delirium symptoms and to explore the interactions between these factors and resident baseline vulnerability.
Prospective, observational cohort study.
Seven long-term care (LTC) facilities.
Two hundred seventy-two LTC residents aged 65 and older with and without delirium.
Weekly assessments (for up to 6 months) of the severity of delirium symptoms using the Delirium Index (DI), environmental risk factors, and number of medications. Baseline vulnerability measures included a diagnosis of dementia and a delirium risk score. Associations between environmental factors, medications, and weekly changes in DI were analyzed using a general linear model with correlated errors.
Six potentially modifiable environmental factors predicted weekly changes in DI (absence of reading glasses, aids to orientation, family member, and glass of water and presence of bed rails and other restraints) as did the prescription of two or more new medications. Residents with dementia appeared to be more sensitive to the effects of these factors.
Six environmental factors and prescription of two or more new medications predicted changes in the severity of delirium symptoms. These risk factors are potentially modifiable through improved LTC clinical practices.