Background:
Delirium is common, distressing and associated with poor outcomes. Despite this,
delirium remains poorly recognised, resulting in worse outcomes. There is an urgent
need for methods to objectively assess for delirium. Physical function has been
proposed as a potential surrogate marker, but few studies have monitored ...
Background:
Delirium is common, distressing and associated with poor outcomes. Despite this,
delirium remains poorly recognised, resulting in worse outcomes. There is an urgent
need for methods to objectively assess for delirium. Physical function has been
proposed as a potential surrogate marker, but few studies have monitored physical
function in the context of delirium. We examined if trajectories of physical function
are affected by the presence and severity of delirium in a representative sample of
hospitalised participants over 65 years.
Methods:
During hospital admissions in 2016, we assessed participants from the DECIDE study
daily for delirium and physical function, using the Hierarchical Assessment of Balance
and Mobility (HABAM). We used linear mixed models to assess the effect of delirium
and delirium severity during admission on HABAM trajectory.
Results:
Of 178 participants, 58 experienced delirium during admission. Median HABAM
scores in those with delirium were significantly higher (indicating worse mobility) than
those without delirium. Modelling HABAM trajectories, HABAM scores at first
assessment were worse in those with delirium than those without, by 0.76 (95% CI:
0.49-1.04) points. Participants with severe delirium experienced a much greater
perturbance in their physical function, with an even lower value at first assessment and
slower subsequent improvement. Conclusions:
Physical function was worse in those with delirium compared to without. This supports
the assertion that motor disturbances are a core feature of delirium and monitoring
physical function, using a tool such as the HABAM, may have clinical utility as a
surrogate marker for delirium and its resolution.
