Prevalence of delirium in German nursing homes: A cross-sectional study.

BACKGROUND

Delirium is a common geriatric syndrome. However, there is a lack of primary data regarding the prevalence of delirium in German nursing homes. The aim of this study was to assess the prevalence of delirium and its motor subtypes, and to identify factors associated with the prevalence of delirium among residents of German nursing homes.

METHODS

This multicenter cross-sectional study was conducted in German nursing homes. Trained nurses collected data over a two-week period in April 2024. The participants were recruited via random sampling. The inclusion criteria were as follows: valid informed consent, age ≥ 65 years, and sufficient German language skills. The exclusion criteria were as follows: aphasia, coma, deafness, or end-of-life status. Delirium screening was conducted using the 4 'A's Test (4AT), and delirium subtypes were classified using the Delirium Motor Subtype Scale (DMSS).

RESULTS

Data from 415 residents across 33 of the 34 participating nursing homes were included in the analysis. Probable delirium (4AT score ≥ 4) was identified in 17.6% of the residents (95% confidence interval [CI]: 13.4-22.7). The results of the DMSS revealed that 43.1% of individuals with delirium presented with a nonmotor subtype (95% CI: 29.8-55.9), 25.0% presented with a hypoactive subtype (95% CI: 15.6-33.3), 18.1% presented with a hyperactive subtype (95% CI: 12.0-24.4), and 13.9% presented with a mixed subtype (95% CI: 6.5-21.3). Multivariate logistic regression analysis revealed that more severe neuropsychiatric symptoms (adjusted odds ratio [AOR] = 1.17, 95% CI: 1.04-1.32), prevalent pain behavior (AOR = 3.67, 95% CI: 1.51-8.93), a medical diagnosis of dementia (AOR = 2.01, 95% CI: 1.12-3.59), and living in the nursing home for ≥ 25 months (AOR = 2.74, 95% CI: 1.08-6.94) were associated with the prevalence of delirium.

CONCLUSION

The findings of this study confirm previous research indicating that delirium is a widespread health issue among residents of nursing homes. Further research is needed to develop training programs focused on the detection and prevention of delirium in nursing homes as well as to enhance knowledge regarding the delirium subtypes. The routine use of simple and rapid screening tools by nurses should also be integrated into standard care.