Delirium upon admission to Swiss nursing homes: a cross-sectional study.
OBJECTIVE
We wished to investigate the prevalence of delirium in patients upon admission to nursing homes and whether or not the previous place of residence predicts delirium.


METHODS
The Resident Assessment Instrument Minimum Data Set (RAI-MDS) and the Nursing Home Confusion Assessment Method (NHCAM) were used to determine whether the previous place of residence (community, nursing home, acute care, psychiatric, rehabilitation hospital) predicted the prevalence of sub-syndromal or full delirium in nursing home residents in three Swiss cantons (n = 11745).


RESULTS
39.7% had sub-syndromal and 6.5% had full delirium. Lower cognitive performance and increased depressive symptoms were significant predictors of higher NHCAM values independent of previous residence. Age, civil status, continence, newly introduced drugs, and basic activities of daily living were predictors in some resident groups. The variance of NHCAM scores explained varied between 25.1% and 32.3% depending on previous residence.


CONCLUSIONS
Sub-syndromal and full delirium are common upon nursing home admission. Increased dependence and depression are consistently associated with higher NHCAM scores. Patients from psychiatric settings have an increased risk of delirium. Although factors associated with delirium depend on a patient's previous residence, all patients must be carefully screened for sub-syndromal and full delirium.
Service of Old Age Psychiatry, Department of Psychiatry, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Prilly, Switzerland. armin.von-gunten@chuv.ch
Armin
A
von Gunten
Urs Peter
UP
Mosimann
D000368:Aged; D000369:Aged, 80 and over; D003693:Delirium / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D010343:Patient Admission; D010360:Patient Transfer; D015995:Prevalence; D012017:Referral and Consultation; D012307:Risk Factors; D013557:Switzerland / Q000453:epidemiology