Cognitive Impairment, Delirium, Dementia
Conditions
Keywords
Delirium, neurocognitive disorder, older adult, isolation precautions
Brief summary
The goal of this observational study is to examine if older patients who need to be under isolation precautions due to multidrug resistant bacteria or other reasons have an increased risk of suffering from delirium or cognitive decline compared to older patients without isolation precautions. To compare this, every person under isolation precautions is compared to other persons of the same age, gender, comorbidities, frailty status and hospital department. Delirium is assessed twice daily with a screening tool named 3D-CAM and cognitive performance is tested by the MOCA-Test six weeks after discharge from hospital and compared to baseline values which are assessed directly after study enrollment. The study duration for each patient participating is from the time of enrollment during hospitalization until 6 weeks after hospital discharge.
Detailed description
Delirium is a common complication in older patients during hospitalization. Its prevention is crucial, as it increases morbidity, mortality, and cognitive impairment. Isolation precautions in hospital may further increase delirium risk due to sensory deprivation and reduced mobility. This study examines the impact of isolation precautions on delirium and neurocognitive disorders in patients ≥70 years. Delirium screening will occur twice daily, with a six-week post-discharge follow-up. A prospective cohort study will compare delirium incidence in isolated patients with a matched non-isolated control group (matched for age, gender, Charlson Comorbidity Index, Frailty and hospital department). The 3D Confusion Assessment Method (3D-CAM) will be used for Delirium screening. Follow-up assessments will evaluate cognitive function and quality of life. Data will be collected during hospitalization (Days 1-5) and six weeks post-discharge.
Interventions
None listed
Sponsors
Universitätsklinikum Hamburg-Eppendorf
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
70 Years to No maximum
Healthy volunteers
No
Inclusion criteria
- hospitalized patients * under isolation precautions for at least 24h * 70 years and above
Exclusion criteria
- no informed consent * intensive care treatment * life expectancy 14 days or less
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Delirium | day 1-5 under isolation precautions | Delirium screened by 3D-Confusion Assessment Method 2 times daily |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cognitive performance | at enrollment and six weeks after discharge from hospital | Measures by Montreal Cognitive Assessment (MOCA). Maximum 15, minimum 0 points. Higher points indicate less functional impairment. |
| Functional state | at enrollment and six weeks after discharge from hospital | Daily activities and functionality assessed by WHO Disability Assessment Schedule (WHODAS 2.0), a questionnaire with 36-items; answers are on a 5-step-Likert-scale; when values are summed up, higher values indicate a worse functional state |
| Quality-of-Life (QoL) | at enrollment and 6 weeks after discharge from hospital | QoL assessed by WHO Quality of Life in older adults (WHO-QOL-OLD) questionnaire |
Countries
Germany
Contacts
CONTACTCynthia Olotu, Dr., MD
PRINCIPAL_INVESTIGATORCynthia Olotu, Dr., MD
University Medical Centre Hamburg, Department of Anaesthesiology
Outcome results
None listed