Difficulties diagnosing delirium in older adults after surgery
Delirium is a medical term for "sudden confusion." It is an abrupt, rapid change in mental function and can cause a wide variety of shifts in behavior ranging from aggression or agitation to feeling sleepy and inactive (or even a combination of several behaviors). When delirium occurs after an older person has had surgery, it's called "post-operative delirium."
Experts still don't always agree on delirium symptoms or diagnoses, even when they are assessing the same symptoms in the same people. A team of researchers from the Netherlands designed a study to look at the accuracy of delirium diagnoses in older adults after surgeries. Their study was published in the Journal of the American Geriatrics Society.
In the study, researchers examined 167 older adults from one to three days after surgery. The researchers used a standard delirium rating scale and recorded the tests on video. Afterwards, the videos were shown to two independent delirium experts. If the experts didn't agree on a diagnosis, the researchers asked a third expert to review the video. A third expert was called in for 21 percent of the evaluations.
According to the researchers, a relatively high number of people with delirium were not diagnosed with the condition by a physician or other healthcare practitioner in the time following their surgery. For example, the researchers found that clinical nurses recognized only 32 percent of the cases of delirium that were diagnosed by the experts reviewing the videotapes.
There is a considerable amount of disagreement among experts about what constitutes delirium among older adults after surgery. The researchers concluded that developing better, more objective screening tools may make it easier and more accurate for experts to diagnose delirium in the future. Understanding the condition–how to recognize and address it — is also an important first step for many older adults and caregivers. You can learn more about delirium at HealthinAging.org.
This summary is from "Recognition of Delirium in Postoperative Elderly Patients: A Multicenter Study." It appears online ahead of print in the April 2017 issue of the Journal of the American Geriatrics Society. The study authors are Tianne Numan, MSc; Mark van den Boogaard, PhD; Adriaan M. Kamper, MD, PhD; Paul J.T. Rood, MSc; Linda M. Peelen, PhD; Arjen J.C. Slooter, MD, PhD.
About the Health in Aging Foundation
This research summary was developed as a public education tool by the Health in Aging Foundation. The Foundation is a national non-profit established in 1999 by the American Geriatrics Society to bring the knowledge and expertise of geriatrics healthcare professionals to the public. We are committed to ensuring that people are empowered to advocate for high-quality care by providing them with trustworthy information and reliable resources. Last year, we reached nearly 1 million people with our resources through HealthinAging.org. We also help nurture current and future geriatrics leaders by supporting opportunities to attend educational events and increase exposure to principles of excellence on caring for older adults. For more information or to support the Foundation's work, visit http://www.HealthinAgingFoundation.org.
About the Journal of the American Geriatrics Society
Included in more than 9,000 library collections around the world, the Journal of the American Geriatrics Society (JAGS) highlights emerging insights on principles of aging, approaches to older patients, geriatric syndromes, geriatric psychiatry, and geriatric diseases and disorders. First published in 1953, JAGS is now one of the oldest and most impactful publications on gerontology and geriatrics, according to ISI Journal Citation Reports®. Visit wileyonlinelibrary.com/journal/JGS for more details.
About the American Geriatrics Society
Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals that has — for 75 years — worked to improve the health, independence, and quality of life of older people. Its nearly 6,000 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists. The Society provides leadership to healthcare professionals, policymakers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information, visit AmericanGeriatrics.org.
Daniel E. Trucil
Related Journal Article