title: Acute delirium and functional decline in the hospitalized elderly patient.
abstract: BACKGROUND
  Delirium is often considered a transient cognitive syndrome. Its effect on long-term physical function, however, has not been well defined.
  
  
  METHODS
  In a prospective study of 325 hospitalized community and nursing home elderly, we analyzed the effect of in-hospital delirium on subsequent physical function. ADL performance was assessed prior to admission, and at 3 and 6 months after hospital discharge.
  
  
  RESULTS
  There was a strong univariate (unadjusted) association between incident delirium and functional decline (p < .02). Delirious subjects lost a mean of almost one ADL, as measured 3 months after hospital discharge. Using multivariate linear regression analysis, with adjusted change in function as the dependent variable, delirium persisted as the sole predictor of loss of function (p = .009) at 3 months after discharge. The functional decline persisted at 6 months after hospital discharge.
  
  
  CONCLUSIONS
  This finding of a nontransient, perhaps permanent consequence of delirium invites reexamination of the definition of delirium from that of an acute, reversible syndrome to one of acute onset with long-term sequelae.
authors.affiliation: North Central Health Care Facilities, Wausau, WI.
authors.forename: A M
authors.initials: AM
authors.lastname: Murray
authors.forename: S E
authors.initials: SE
authors.lastname: Levkoff
authors.forename: T T
authors.initials: TT
authors.lastname: Wetle
authors.forename: L
authors.initials: L
authors.lastname: Beckett
authors.forename: P D
authors.initials: PD
authors.lastname: Cleary
authors.forename: J D
authors.initials: JD
authors.lastname: Schor
authors.forename: L A
authors.initials: LA
authors.lastname: Lipsitz
authors.forename: J W
authors.initials: JW
authors.lastname: Rowe
authors.forename: D A
authors.initials: DA
authors.lastname: Evans
mesh_terms: D000203:Activities of Daily Living; D000208:Acute Disease; D000368:Aged; D001900:Boston; D003693:Delirium / Q000503:physiopathology*; D005260:Female; D015577:Geriatric Assessment; D006760:Hospitalization; D006784:Hospitals, Teaching; D006801:Humans; D016014:Linear Models; D008297:Male; D009735:Nursing Homes; D011446:Prospective Studies; D012307:Risk Factors