Acute confusion indicators: risk factors and prevalence using MDS data

Area of Science:

• Gerontology
• Nursing Science
• Clinical Research

Background:

• Acute confusion is a common and serious issue in long-term care (LTC) settings.
• Existing conceptual models for acute confusion risk were primarily developed in acute care settings.
• Validation of these models in LTC populations is necessary to identify specific risk factors.

Purpose of the Study:

• To validate a conceptual model of acute confusion risk factors in a long-term care (LTC) setting.
• To identify specific variables associated with probable acute confusion in LTC residents.
• To inform nursing practice, education, and research regarding acute confusion prevention and management.

Main Methods:

• Analysis of Long-term care (LTC) Minimum Data Set (MDS) data from a Midwestern state.
• Cross-sectional study design involving 2,318 residents.
• Univariate and unconditional stepwise logistic regression analyses were performed to identify risk variables for acute confusion.

Main Results:

• The prevalence of probable acute confusion was 13.98% (n = 324).
• Inadequate fluid intake was a highly significant predictor of acute confusion (OR 3.40, p < .0001).
• Other significant risk factors included a diagnosis of dementia and a fall within the last 30 days.

Conclusions:

• Inadequate fluid intake is a critical, modifiable risk factor for acute confusion in long-term care.
• Dementia and recent falls are also significant contributors to acute confusion risk in this population.
• Findings support the need for targeted interventions focusing on hydration and fall prevention in LTC settings.