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Updated: Jul 14, 2026
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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Delirium in elderly general medical inpatients: a prospective study
R K Iseli1, C Brand, M Telford
1Department of Geriatric Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia. rkiseli@gmail.com
Internal Medicine Journal
|May 23, 2007
Summary
Delirium affects 18% of older medical inpatients. Pre-existing cognitive impairment and low scores on the Abbreviated Mental Test Score (AMTS) predict delirium, yet routine cognitive assessments are lacking.
Area of Science:
- Geriatric Medicine
- Neuroscience
- Public Health
Background:
- Delirium significantly impacts hospital resource utilization, accounting for over 49% of US hospital days.
- Limited Australian data exist on the prevalence and management of delirium in older adults.
- This study addresses the need for local data on delirium in Australian hospitals.
Purpose of the Study:
- To determine the prevalence and incidence of delirium in older medical inpatients.
- To identify the incidence of known delirium risk factors.
- To assess current practices in identifying and managing at-risk patients.
Main Methods:
- Inclusion criteria: patients aged 65+ admitted to a general medical unit.
- Screening tools: Abbreviated Mental Test Score (AMTS) and chart review.
- Diagnostic criteria: Confusion Assessment Method for diagnosed delirium or AMTS < 8. Barthel Index (BI) and risk factors were recorded.
Main Results:
- Prevalent delirium found in 18% (19/104) and incident delirium in 2% (2/85) of participants.
- Strong predictors of prevalent delirium: pre-existing cognitive impairment and admission AMTS < 8.
- Associated factors: age > 80, low Barthel Index (< or = 50), high-risk medications, and electrolyte disturbance. Delirium was unrecognized in 21% of cases.
Conclusions:
- Pre-existing cognitive impairment and admission AMTS are significant predictors of delirium in older medical patients.
- Formal cognitive assessment is underutilized in this population.
- Routine cognitive assessment could improve delirium recognition and management.
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