Researchers Test New Approaches to Prevent Delirium in Older Adults

Researchers supported by the National Institute on Aging (NIA) are testing new pharmaceutical and non-pharmaceutical methods for preventing delirium in older adults. Luci Roberts in NIA's Division of Neuroscience says people who have had postoperative delirium experience a more precipitous rate of cognitive decline over subsequent years on average. Two multipronged approaches that provide patients with appropriate medical care, physical and mental engagement, and emotional support have prevented delirium: the Hospital Elder Life Program can reduce the occurrence of delirium by 40 percent in hospitalized older adults and lower the probability of cognitive and functional decline, and also reduce hospital length of stay and falls. Meanwhile, the ABCDEF Bundle can significantly lower the incidence of delirium, boost survival, and reduce intensive care unit (ICS) readmission. Both approaches highlight coordinated care by the surgical team, postoperative nurses, and patients' family members to prevent or minimize delirium. Experts say insurance policies need to further incentivize delirium interventions. In terms of pharmaceutical investigation, NIA is funding a four-year clinical trial of postsurgical intravenous acetaminophen in persons 60 and older undergoing cardiac surgery, to see if it prevents delirium. Nondrug interventions being explored include improved sleep habits, cognitive training, physical activity before or after surgery, and combined cognitive and physical activity for patients out of the ICU.