title: A longitudinal study on delirium in nursing homes.
abstract: OBJECTIVE
  To investigate the evolution of delirium of nursing home (NH) residents and their possible predictors.
  
  
  METHODS
  Post-hoc analysis of a prospective cohort assessment.
  
  
  METHODS
  Ninety NHs in Switzerland.
  
  
  METHODS
  Included 14,771 NH residents.
  
  
  METHODS
  The Resident Assessment Instrument Minimum Data Set and the Nursing Home Confusion Assessment Method were used to determine follow-up of subsyndromal or full delirium in NH residents using discrete Markov chain modeling to describe long-term trajectories and multiple logistic regression analyses to determine predictors of the trajectories.
  
  
  RESULTS
  We identified four major types of delirium time courses in NH. Increasing severity of cognitive impairment and of depressive symptoms at the initial assessment predicted the different delirium time courses.
  
  
  CONCLUSIONS
  More pronounced cognitive impairment and depressive symptoms at the initial assessment are associated with different subsequent evolutions of delirium. The presence and evolution of delirium in the first year after NH admission predicted the subsequent course of delirium until death.
authors.affiliation: Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, Prilly-Lausanne, Switzerland. Electronic address: armin.von-gunten@chuv.ch.
authors.forename: Armin
authors.initials: A
authors.lastname: von Gunten
authors.forename: Urs Peter
authors.initials: UP
authors.lastname: Mosimann
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Antonietti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000150:complications / Q000523:psychology; D003693:Delirium / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D003863:Depression / Q000150:complications; D018450:Disease Progression; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D009735:Nursing Homes; D012307:Risk Factors; D013557:Switzerland / Q000453:epidemiology
keywords: Delirium; elderly; nursing home; time course