NEW YORK, NY / American Geriatrics Society / May 14, 2010
Preventing and Effectively Treating Delirium in Elderly
May Also Lower Their Risks of Permanent Cognitive
Notes Sharon Inouye, MD,
Recipient of American Geriatrics
Henderson State-of-the Art Award
ORLANDO, Florida - The prevention and treatment of delirium in older
adults, which has been shown to save money and seniors' lives, may also
lower older people's risks of permanent cognitive impairment, Sharon K.
Inouye, MD, MPH, told an audience of hundreds of geriatrics healthcare
professionals here yesterday at the American Geriatrics Society's (AGS')
Annual Scientific Meeting.
During the annual meeting, which began Wednesday and runs through
Saturday, the AGS presented Dr. Inouye with its Edward Henderson
State-of-the-Art Award in recognition of her seminal research into
delirium and functional decline in hospitalized older adults. The award
honors the late Dr. Henderson, a leader of the AGS. Recipients of the
award deliver the meeting's annual Henderson State-of-the-Art Lecture.
"Delirium may provide the unique opportunity for early intervention
and prevention of permanent cognitive damage," said Dr. Inouye, who is
the director of the Aging Brain Center, Hebrew SeniorLife and a
professor of medicine at Harvard Medical School. She holds the Milton
and Shirley F. Levy Family Chair at Hebrew Senior Life's Institute for
Dr. Inouye has published more than 140 papers on delirium -- an
acute, temporary cognitive disorder characterized by relatively rapid
onset and variable symptoms including difficulty maintaining attention.
In addition to developing a highly effective screening protocol for
delirium called the Confusion Assessment Method (CAM), she and
colleagues have also developed a multifaceted intervention strategy, the
Hospital Elder Life Program (HELP), to prevent delirium by targeting
risk factors for the syndrome. In the first study to show that a
substantial number of cases of delirium are preventable, the
intervention reduced risks of delirium by nearly 40% and cut healthcare
costs significantly. The HELP model, which also significantly reduces
the incidence of falls among seniors, is now being disseminated
internationally. It is in use at more than 60 sites in six countries.
Common and often overlooked, delirium causes significant morbidity
and mortality in older hospitalized patients. In-hospital mortality
ranges from 22 to76 percent, Dr. Inouye noted.
"We can't manage delirium or reduce complications unless we can
recognize it," she pointed out during her lecture, which provided an
overview of the latest research and state-of-the-art approaches to
screening for, diagnosing, treating and preventing delirium.
"All of this is just the tip of the iceberg regarding what we need to
know about delirium," concluded Dr. Inouye, who hopes to undertake
additional research that would, among other things, examine whether
education or other activities that build "cognitive reserve capacity,"
can protect against delirium, and further investigate the relationship
between delirium and dementia. If the two are linked, preventing and
effectively managing delirium could help lower risks of dementia. [rc]
© 2010 The American Geriatrics Society