Efficacy of Non-Pharmacological Interventions to Prevent and Treat Delirium in Older Patients: A Systematic Overview. The SENATOR Project ONTOP Series

PLoS One

Abraha, I., Trotta, F., et al. (2015).

PLoS One, 10(6), e0123090.

<div>This systematic review investigates the effects of non-pharmacological interventions to prevent and treat delirium in hospitalized older adults (i.e., aged 60 years or older). While this review contains a variety of interventions, this article summary only reports findings relevant to the scope of speech-language pathology.&nbsp;</div>

European Union Seventh Framework Program

<div>The data in this systematic review are included in another document which can be found in the Associated Article section below.&nbsp;</div>

Not specified

<div>Experimental studies found within relevant systematic reviews</div>

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<div>Multicomponent interventions had the following effects when used to prevent delirium in hospitalized older adults:</div> <div> <ul> <li><strong>Surgical patients: </strong>Overall, multicomponent interventions reduced delirium incidence by 29% in patients seen in surgical settings (relative risk [RR] = 0.71; Moderate Quality of Evidence). Mixed results were reported for delirium duration, delirium severity, and hospital length of stay. No significant treatment effect was reported on mortality up to 1 year post-discharge.</li> <li><strong>Orthopedic surgery: </strong>Multicomponent interventions reduced delirium incidence by 43% in patients receiving orthopedic surgery (RR = 0.57; Moderate Quality of Evidence).</li> <li><strong>Other medical units:</strong> Multicomponent interventions reduced delirium incidence by 35% in patients seen in other medical units (RR = 0.65; Moderate Quality of Evidence). Mixed findings were reported for hospital length of stay, delirium severity, mortality, functional decline, and cognitive performance. One study reported no treatment effect on delirium duration.</li> </ul> <div>Limitations to these findings include heterogeneity between studies and a lack of cost effectiveness data.</div> </div>

<div>Overall, multicomponent interventions had inconclusive effects when used to treat active delirium in hospitalized, older adults (Very Low Quality of Evidence). Additional findings included:&nbsp;</div> <div> <ul> <li>Within two studies, multicomponent programs had no impact on functional status in patients with active delirium.</li> <li>One randomized control trial reported improved delirium identification for older adults in skilled nursing facilities, however, there was no impact on delirium duration.&nbsp;</li> </ul> <div>Additional research is indicated due to low quality of evidence, limited available research, and heterogeneity between studies.&nbsp;</div> </div>