Grant: Travel Awards - Institute Community Support

Delirium is a severe neuropsychiatric syndrome characterized by episodic disturbances in cognition, consciousness, and attention. Long-term care (LTC) facilities have a high burden of cognitive impairment and dementia which, in turn, are associated with a six-fold increase in the risk of developing delirium. The Delirium Index (DI) measures changes in the severity of delirium symptoms. While it has been validated using acute care medical inpatients aged 65 and older, it has also been used in the LTC setting. DI validity in LTC is questionable due to the criteria used to score psychomotor agitation, which only considers the use of physical restraints in its scoring criteria. Given that alternative management strategies, including non-pharmacological strategies and prescribing antipsychotic medication, are generally preferred for residents with agitation and aggression in LTC, the current DI tool may underestimate delirium severity in this population. The objective of this study is to estimate the extent to which DI scores are attenuated among geriatric LTC residents due to the current scoring criteria for psychomotor agitation. Secondary analysis of the 'PREvention Program for Alzheimer's RElated Delirium' (PREPARED) cluster randomized trial data, in which weekly DI assessments are collected for 20 weeks on a large sample of geriatric LTC residents will be used. In addition, data obtained via direct weekly observations, pharmacy records, and resident charts will be collected to document the presence of other psychomotor agitation management strategy options that are used. This study is expected to shed light on the validity of the DI in LTC, and more specifically, whether the item pertaining to psychomotor agitation merits a modification for use in this population.