Pilot study of a nonpharmacological intervention for delirium superimposed on dementia

Delirium is a common neuropsychiatric syndrome that occurs most frequently in older adults with dementia and is referred to as delirium superimposed on dementia (DSD). Our aim in this pilot project was to demonstrate that implementation of cognitively stimulating activities is clinically feasible and has potential to reduce delirium severity and duration and functional loss in post-acute care settings. We randomized newly admitted participants with DSD to treatment (n = 11) and control (n = 5) conditions and conducted daily blinded assessments of delirium, delirium severity, and functional status for up to 30 days. The control group had a significantly greater decrease in physical function and mental status over time compared with the intervention group. Delirium, severity of delirium, and attention approached significance, and improvement over time favored the intervention group. Although not statistically significant, a difference in mean (7.0 versus 3.27) and median (7.0 versus 3.0) days with delirium was found, with the control group having more days of delirium.