Preventing delirium: should non-pharmacological, multicomponent interventions be used? A systematic review and meta-analysis of the literature

Delirium is a complex neuropsychiatric syndrome that is common among elderly inpatients. It has been associated with increased mortality, longer hospital stays, cognitive and functional decline and increased institutionalisation rates. Multicomponent interventions, a series of non-pharmacological st...

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Bibliographic Details
Published in:Age and ageing 2015-03, Vol.44 (2), p.196-204
Main Authors: Martinez, Felipe, Tobar, Catalina, Hill, Nathan
Format: Article
Language:English
Subjects:
Accidental Falls - prevention & control
Age Factors
Aged
Aging
Chi-Square Distribution
Clinical trials
Combined Modality Therapy
Company business management
Delirium
Delirium - diagnosis
Delirium - mortality
Delirium - prevention & control
Delirium - psychology
Elderly
Health aspects
Humans
Incidence
Inpatients
Management
Neuropsychology
Nursing
Odds Ratio
Older people
Prevention
Primary Prevention - methods
Risk Factors
Systematic review
Treatment Outcome
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Summary:Delirium is a complex neuropsychiatric syndrome that is common among elderly inpatients. It has been associated with increased mortality, longer hospital stays, cognitive and functional decline and increased institutionalisation rates. Multicomponent interventions, a series of non-pharmacological strategies frequently handled by nursing staff, might be useful for prevention. To assess the efficacy of multicomponent interventions in preventing incident delirium in the elderly. A systematic review of randomised trials was undertaken. Two independent reviewers performed iterative literature searches in seven databases without language restrictions. Grey literature repositories were considered as well. The quality of included trials was assessed by using the criteria established by the Cochrane Collaboration. When possible, data were synthesised into a meta-analysis. Heterogeneity was assessed using the χ2 and I2 tests. A total of 21,788 citations were screened, and seven studies of diverse quality were included in the review, comprising 1,691 participants. Multicomponent interventions significantly reduced incident delirium (relative risk [RR] 0.73, 95% confidence interval [CI] 0.63-0.85, P
ISSN:0002-0729
1468-2834
DOI:10.1093/ageing/afu173