The delirium and population health informatics cohort study protocol: ascertaining the determinants and outcomes from delirium in a whole population

Abstract

BackgroundDelirium affects 25% of older inpatients and is associated with long-term cognitive impairment and future dementia. However, no population studies have systematically ascertained cognitive function before, cognitive deficits during, and cognitive impairment after delirium. Therefore, there is a need to address the following question: does delirium, and its features (including severity, duration, and presumed aetiologies), predict long-term cognitive impairment, independent of cognitive impairment at baseline?MethodsThe Delirium and Population Health Informatics Cohort (DELPHIC) study is an observational population-based cohort study based in the London Borough of Camden. It is recruiting 2000 individuals aged ≥70 years and prospectively following them for two years, including daily ascertainment of all inpatient episodes for delirium. Daily inpatient assessments include the Memorial Delirium Assessment Scale, the Observational Scale for Level of Arousal, and the Hierarchical Assessment of Balance and Mobility. Data on delirium aetiology is also collected. The primary outcome is the change in the modified Telephone Interview for Cognitive Status at two years.DiscussionDELPHIC is the first population sample to assess older persons before, during and after hospitalisation. The cumulative incidence of delirium in the general population aged ≥70 will be described. DELPHIC offers the opportunity to quantify the impact of delirium on cognitive and functional outcomes. Overall, DELPHIC will provide a real-time public health observatory whereby information from primary, secondary, intermediate and social care can be integrated to understand how acute illness is linked to health and social care outcomes.

The role of illness acuity on the association between frailty and mortality in emergency department patients referred to internal medicine

“…For the most part, this information comes from a history given by a knowledgeable informant. Other designs, such as the DELPHIC study, are better suited to that [ 29 ].…”

A CRHR1 antagonist prevents synaptic loss and memory deficits in a trauma-induced delirium-like syndrome

“…Physical trauma or complicated, long-lasting surgical operations are closely associated with neuropsychiatric syndromes that are subsumed as acute physical stress response/disorder or delirium [ 40 , 41 ]. In industrial countries, delirium affects ~15% of all inpatients [ 42 , 43 ] and is highly correlated with higher mortality and extended hospital stays [ 44 ]. Despite the great efforts of scientists and clinicians to unravel the pathophysiology of delirium and to develop effective treatment options, this acute and mostly transient neuropsychiatric disorder is still far from being completely understood.…”

Development and feasibility of a smartphone-based test for the objective detection and monitoring of attention impairments in delirium in the ICU

“…Nonetheless, overall the DelApp-ICU was found to be a promising tool for detecting and monitoring arousal and attention impairments in delirium in the ICU. The use of DelApp and variant tests in several completed and ongoing research studies provides evidence supporting its feasibility [16,18,[30][31][32][33].…”