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Updated: Jun 12, 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
Hospital use, institutionalisation and mortality associated with delirium.
Eamonn M P Eeles1, Ruth E Hubbard, Susan V White
1Department of Geriatric Medicine, Cardiff University, Academic Centre, University Hospital Llandough, Penarth, South Wales, UK. eamonn.eeles2@wales.nhs.uk <eamonn.eeles2@wales.nhs.uk>
Age and Ageing
|June 18, 2010
Summary
Delirium significantly increases mortality risk and institutionalization in older adults, even years after the initial event. This study highlights how delirium can exacerbate existing vulnerabilities, leading to adverse long-term health outcomes.
Area of Science:
- Gerontology
- Neurology
- Critical Care Medicine
Background:
- Delirium is a serious disturbance of consciousness affecting older adults, who are more susceptible due to cognitive impairment, frailty, and polypharmacy.
- Older patients are at higher risk for delirium due to pre-existing conditions and multiple medications.
Purpose of the Study:
- To investigate if delirium disproportionately affects the most vulnerable older adults.
- To determine the association between delirium and long-term adverse health outcomes in elderly patients.
Main Methods:
- A prospective cohort study of 278 medical patients aged 75 years and older.
- Patients were screened for delirium upon admission and regularly throughout their hospital stay.
- Follow-up for 5 years assessed institutionalization and mortality rates, with prior hospital days also recorded.
Main Results:
- Delirium was identified in 103 patients, who had a significantly shorter median time to death (162 days) compared to those without delirium (1,444 days).
- Adjusted analysis revealed delirium increased the risk of death (hazard ratio 2.0-3.5) and was linked to higher institutionalization rates in the first year post-discharge.
- While patients with delirium were older and had more comorbidities, they did not have more prior hospitalizations.
Conclusions:
- Delirium is strongly associated with increased mortality and institutionalization for up to 5 years in older adults.
- The study suggests that delirium may transform underlying vulnerability into tangible adverse outcomes.
- Individuals may appear to compensate for vulnerabilities before delirium, but its impact can lead to irreversible negative health consequences.
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