Cognitive Impairment - Delirium

With a research focus on the early stages of delirium in emergency medicine, GEAR could lead the field in studying interventions.
Delirium is multifactorial in its etiology, with histories of cognitive impairment and dementia being key risk factors. Individuals identified as experiencing delirium in general and in the emergency department are more likely to develop dementia as older adults. Yet, almost three decades of research has shown that delirium and dementia are under-recognized in emergency departments, despite a proliferation of screening tools. Under-recognition in the emergency department leads to under-recognition in inpatient services, which has broad-reaching consequences, such as longer lengths of hospital stays, lower patient satisfaction, accelerated cognitive declines, and increased health care costs.

Best Practice Notes

Multiple screening instruments are available; however, EDs should choose wisely based on departmental considerations, such as:

Cochrane Reviews found that none of the interventions implemented outside of ED settings were effective; however, EDs could implement some common-sense interventions:

Top Research Priority Areas

Top voted Cognitive Impairment in Delirium research priority areas ranked during the 2019 GEAR Consensus conference are as follows: