Delirium and dementia, acute hospital illness in older people (>70 years) Mental and Behavioural Disorders
Conditions
Interventions
After consenting the participant, the researcher will ask the research questions and administer the thinking and memory tests and mobility assessment. This should take not more than one hour but may n
Sponsors
University of Oxford
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Adult hospital patients aged >=70 years with unplanned admission to OUHFT or RBHFT or assessed in the SDECs 2. Patient is willing and able to give informed consent for participation in the study OR Seek advice from a personal consultee (family member, friend or carer). If a personal consultee is unavailable, advice will be sought from a member of the hospital staff who is not part of the research team (professional consultee)
Exclusion criteria
Exclusion criteria: 1. Moribund status 2. Nursing Care home residence 3. Severe dementia with high degree of dependency e.g. bedbound
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1.1. Delirium subtype, duration and severity measured using 4AT (Rapid test for delirium), Memorial Delirium Assessment Scale (MDAS), Confusion Assessment Method (CAM), Abbreviated Mental Test Score (AMTS), Observational Study of Arousal (OSLA), Richmond Agitation Scale at baseline 1.2. Transient cognitive impairment measured using Abbreviated Mental Test Score (AMTS), Montreal Cognitive Assessment (MoCA) at baseline and 3 months 1.3. Dementia and dementia subtype diagnosis according to the DSM-5 criteria (major neurocognitive disorder) and accepted sub-type diagnostic criteria informed by clinical assessment including cognitive and functional assessments at 3 months, 1 and 3 years 2.1. Demographics (baseline only) and health factors collected using Electronic Patient Records (EPR) at baseline, 3 months, 1 and 3 years 2.2. Acute illness severity measured using EPR at baseline 2.3. Frailty measured using Rockwood Clinical Frailty Scale at baseline, 3 months, 1 and 3 years. 2.4. Multimorbidity defined by the Charlson index at baseline, 3 months, 1 and 3 years. 2.5. Cognitive profile-participant assessment (AMTS, MoCA, OCS-plus) collected at baseline, 3 months, 1 and 3 years. 2.6. Cognitive profile- Informant assessment (Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), 10-point Neuropsychiatric Inventory ) at baseline and 3 years 3. Blood biomarkers collected at baseline and 3 months for inflammatory markers, neurodegeneration markers, genetic profile. 4. Brain imaging at baseline for global and regional atrophy, white matter changes defined using visual rating scales and semi-automated image analysis techniques. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1.1. Outcome measured using length of stay, readmission within 30-days, and mortality from electronic records and European Quality of Life Score (Euroqol) at 3 months, 1 and 3 years 1.2. Function measured using Hospital Assessment of Balance and Mobility (HABAM), Nottingham Extended Activities of Daily Living (ADL), Timed Up and Go Test (TUG) and modified Rankin Scale (pre-morbid at baseline) at baseline, 3 months, 1 and 3 years 2. Added Value of advanced proton-counting CT brain imaging for quantifying brain atrophy and cerebrovascular disease including small vessel disease | — |
Countries
England, United Kingdom
Outcome results
None listed