Improving Delirium Identification in Hospitalized Older Adults

Delirium affects one-third of hospitalized older adults and is associated with prolonged length of stay, institutional discharge, long-term functional and cognitive decline, Alzheimer disease and related dementias (AD/ADRD), and death. Moreover, the costs of delirium exceed $182 billion annually in the US alone. Despite these compelling data, accurate identification of delirium remains challenging, with more than half of delirium going unrecognized in routine care. While delirium prevention has advanced substantially, delirium treatment, which relies on early and accurate identification, lags. More than 40 tools are available for delirium assessment, ranging from short structured screens to in-depth reference standards. Evidence on how to implement these tools to improve delirium identification at the bedside, including which tool to use, who should administer it, how often, and how to educate and engage the care team, remains limited.

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