Home › Research › Costs and economics
Delirium in older people
John B. Young, Sharon K. Inouye. BMJ, 2007-04-19
Topic: Health services, long-term care and technology
Few ill health situations are more degrading to people of any age than loss of reasoning, faculties, and personhood. These are the unpleasant consequences of delirium—a common condition affecting ill older people, particularly those with some degree of dementia. It is characterised by recent onset of fluctuating inattention and confusion, linked to one or more triggering factors. #### SUMMARY POINTS Delirium is a major burden to healthcare services and has been largely ignored by health service planners and practitioners.1 Moreover, healthcare systems and services often unintentionally stimulate or substantially aggravate the development of delirium in older people.2 This might be understandable if delirium was unavoidable or untreatable, but the existing evidence base for delirium is sufficiently robust for prevention or attenuation of the condition to be a realistic proposition. There is a pressing need to take this action because the outcomes for delirium are poor: it contributes to substantial morbidity and mortality, causes considerable distress to patients and families, and is expensive—an estimated additional $2500 (£1275; €1875) per patient (a $6.9bn annual expenditure for Medicare in 2004).3 We searched Medline and the Cochrane Library from 1996 to 2006. We drew additional material from our personal libraries of delirium references, focusing particularly on systematic reviews. Delirium is an important problem for all clinical services providing care for older people, particularly emergency departments; general medical, elderly care, surgical, and …
Key findings
- These are the unpleasant consequences of delirium—a common condition affecting ill older people, particularly those with some degree of dementia.
- It is characterised by recent onset of fluctuating inattention and confusion, linked to one or more triggering factors. #### SUMMARY POINTS Delirium is a major burden to healthcare services and has been largely ignored by health service planners and practitioners.1 Moreover, healthcare systems and services often unintentionally stimulate or substantially aggravate the development of delirium in older people.2 This might be understandable if delirium was unavoidable or untreatable, but the existing evidence base for delirium is sufficiently robust for prevention or attenuation of the condition to be a realistic proposition.
- There is a pressing need to take this action because the outcomes for delirium are poor: it contributes to substantial morbidity and mortality, causes considerable distress to patients and families, and is expensive—an estimated additional $2500 (£1275; €1875) per patient (a $6.9bn annual expenditure for Medicare in 2004).3 We searched Medline and the Cochrane Library from 1996 to 2006.
- We drew additional material from our personal libraries of delirium references, focusing particularly on systematic reviews.
- Delirium is an important problem for all clinical services providing care for older people, particularly emergency departments; general medical, elderly care, surgical, and …
New to this subject? Start with our plain-English guide: Costs & economics →
Study details
- Evidence strengthLow
How this study scored 43/100
Published in a leading specialty journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 25 of the 58 points we could judge it on, which is 43 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (BMJ) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2007 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 17446616) |
| Free to read | 2 / 2 | Free to read |
| Points | 25 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 25 of the 58 points we could judge it on is 43 out of 100. |
| Total | 43 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Free copy unknown: no free-copy check has an answer for this record yet. That does not mean it is paywalled.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Young, J. B., & Inouye, S. K. (2007). Delirium in older people. BMJ. https://doi.org/10.1136/bmj.39169.706574.ad
Vancouver
Young JB, Inouye SK. Delirium in older people. BMJ. 2007. doi:10.1136/bmj.39169.706574.ad. PMID: 17446616.
BibTeX
@article{young2007-17446616,
author = {Young, John B. and Inouye, Sharon K.},
title = {{Delirium in older people}},
journal = {BMJ},
year = {2007},
doi = {10.1136/bmj.39169.706574.ad},
pmid = {17446616},
url = {https://doi.org/10.1136/bmj.39169.706574.ad}
}
Related studies in Costs and economics
Also tagged “cholinesterase”
271 studies in the library carry the topic tag “cholinesterase”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 271 tagged studies.