Association between frailty and delirium in older adult patients discharged from hospital

Henk Verloo,1 Céline Goulet,2 Diane Morin,3,4 Armin von Gunten51Department Nursing Sciences, University of Applied Sciences, Lausanne, Switzerland; 2Faculty of Nursing Science, University of Montreal, Montreal, QC, Canada; 3Institut Universitaire de Formation et Recherche en Soins (IUFRS), Faculty of Biology and Medicine, University of Lausanne, Lausanne University Hospital, Lausanne, Switzerland; 4Faculty of Nursing Science, Université Laval, Québec, Canada; 5Department of Psychiatry, Service Universitaire de Psychiatrie de l’Age Avancé (SUPAA), Lausanne University Hospital, Prilly, SwitzerlandBackground: Delirium and frailty – both potentially reversible geriatric syndromes – are seldom studied together, although they often occur jointly in older patients discharged from hospitals. This study aimed to explore the relationship between delirium and frailty in older adults discharged from hospitals.Methods: Of the 221 patients aged >65 years, who were invited to participate, only 114 gave their consent to participate in this study. Delirium was assessed using the confusion assessment method, in which patients were classified dichotomously as delirious or nondelirious according to its algorithm. Frailty was assessed using the Edmonton Frailty Scale, which classifies patients dichotomously as frail or nonfrail. In addition to the sociodemographic characteristics, covariates such as scores from the Mini-Mental State Examination, Instrumental Activities of Daily Living scale, and Cumulative Illness Rating Scale for Geriatrics and details regarding polymedication were collected. A multidimensional linear regression model was used for analysis.Results: Almost 20% of participants had delirium (n=22), and 76.3% were classified as frail (n=87); 31.5% of the variance in the delirium score was explained by frailty (R2=0.315). Age; polymedication; scores of the Confusion Assessment Method (CAM), instrumental activities of daily living, and Cumulative Illness Rating Scale for Geriatrics; and frailty increased the predictability of the variance of delirium by 32% to 64% (R2=0.64).Conclusion: Frailty is strongly related to delirium in older patients after discharge from the hospital.Keywords: Edmonton Frailty Scale, delirium risk factors, cognitive impairment, physical impairmentA Letter to the Editor has been received and published for this article