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doctor explaining brain model
Project
Project Type - Pilot Projects

Delirium and Dementia Diagnosis in Hospitalized Older Adults

Enhancing delirium and dementia diagnoses in hospitals
Latin America & Caribbean

Overview

Delirium and dementia are common brain disorders in older adults, leading to health complications and decreased quality of life. Delirium is a sudden, usually temporary, state of confusion often triggered by illness or medication. Dementia is a progressive decline in cognitive function due to brain changes. Both conditions are frequently misdiagnosed or overlooked in hospital settings, leading to suboptimal care. We aim to improve delirium and dementia diagnosis in hospitalized older adults by exploring several bedside cognitive and functional assessments to identify the subset of tests with the highest diagnostic accuracy.
 

Project Details

The project will be conducted in a hospital in Sao Paulo, Brazil, where we will recruit older adults and their caregivers. The goal is to identify a valid, accurate, and practical battery of cognitive and functional tests to distinguish between delirium, dementia, and a condition known as delirium superimposed on dementia, where a person experiences both conditions simultaneously. To accomplish our goal, we have curated a battery of tests (direct patient assessments, patient observation tools, and informant surveys) that capture the range of symptoms across these conditions and are likely feasible in busy hospital workflows. Tests will be administered to 150 hospitalized older adults at admission (day 1), with some measures repeated on days 2 and 3. Tests, combinations of tests, and test items will be evaluated for their ability to discriminate between delirium and dementia, administration time, and user feedback on clarity and usability. Analyses will be repeated excluding tests requiring an informant to identify optimal approaches when an informant is not available or reliable. Impact: The potential impact of this project is significant. By improving the accuracy of delirium and dementia diagnosis, we can provide information to foster appropriate care. This could lead to better health outcomes, improved quality of life, and reduced healthcare costs. Moreover, our results could facilitate new hospital guidelines for diagnosing these conditions, promoting changes in how they are identified and managed, not only in Brazil but also globally. This pilot project's findings will guide future research, refining and testing our diagnostic tools in different settings and populations. The end goal is to standardize delirium and dementia diagnosis in hospitals, enhancing brain health in older adults.