gms | German Medical Science

Background and Purpose: Delirium is a common, serious, and often undetected syndrome that can have severe consequences for people concerned. According to current scientific knowledge, elderlies with limited cognitive reserves are especially exposed to develop a delirium.

Methods: After creating an efficient search string, using selected words and mesh-terms, relevant databases (Medline, PsychInfo, Cochrane Library, Cinahl, and Web of Science) were systematically searched. Publication period and study design were not limited. Based on predefined inclusion (e. g. acute hospital), and exclusion criteria (long-term care) two independent reviewers screened 3.809 identified records. 77 full-text articles were assessed for eligibility. Several studies were included in the evaluation.

Research Focus: Older people with dementia or MCI belong to the particularly vulnerable groups in the acute hospital. As a result, detection, prevention and treatment of delirium are highly significant in the geriatric setting. Therefore, the objectives of this systematic review were to identify, systematize, and to examine these programs.

Methodological and Theoretical Focus: Multimodal and non-pharmacological programs are particularly effective. A descriptive analysis was carried out to explore whether they are suitable for the special needs of geriatric patients.

Results: Most interventions are created to prevent delirium. Interventions for the non-pharmacological delirium-treatment are rare. Many programs were adapted from the Hospital Elder Life Program (HELP, Inouye 1999), or they are based on the NICE-guidelines (2010). Interventions, especially for people with dementia/MCI, are still hardly available.

Conclusions: Further research is needed in the field of delirium interventions, especially for the needs of hospitalized geriatric patients.