May 14, 2010

USA: Effectively Treating Delirium in Elderly Can Save Seniors' Lives

NEW YORK, NY / American Geriatrics Society / May 14, 2010

Preventing and Effectively Treating Delirium in Elderly 
Can Save Seniors' Lives. 
May Also Lower Their Risks of Permanent Cognitive Loss,

Notes Sharon Inouye, MD,
Recipient of American Geriatrics Society's
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 Aging Research.

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