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The Impact of Delirium on Recovery in Geriatric Rehabilitation after Acute Infection
J. Minnema, HA. Polinder-Bos, M. Cesari, F. Dockery, IHJ. Everink, BN. Francis, AL. Gordon, S. Grund, LM. Perez Bazan, K. Eruslanova, E. Topinková, MA. Vassallo, MC. Faes, LS. van Tol, MAA. Caljouw, WP. Achterberg, ML. Haaksma, EU-COGER...
Language English Country United States
Document type Journal Article, Multicenter Study
- MeSH
- Activities of Daily Living * MeSH
- COVID-19 * MeSH
- Delirium * MeSH
- Geriatric Assessment MeSH
- Cohort Studies MeSH
- Quality of Life * MeSH
- Humans MeSH
- Recovery of Function * MeSH
- SARS-CoV-2 MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Geographicals
- Europe MeSH
OBJECTIVES: Delirium is common during acute infection in older patients and is associated with functional decline. Geriatric rehabilitation (GR) can help older patients to return to their premorbid functional level. It is unknown whether delirium affects GR outcomes in patients with acute infection. We evaluated whether delirium affects trajectories of activities of daily living (ADL) and quality of life (QoL) recovery in GR after COVID-19 infection. DESIGN: This study was part of the EU-COGER study, a multicenter cohort study conducted between October 2020 and October 2021. SETTING AND PARTICIPANTS: Participants were recruited after COVID-19 infection from 59 GR centers in 10 European countries. METHODS: Data were collected at GR admission, discharge, and at the 6-week and 6-month follow-ups. Trajectories of ADL [using the Barthel index (BI)] and QoL [using the EuroQol-5 Dimensions-5 Level (EQ-5D-5L)] recovery were examined using linear mixed models. RESULTS: Of the 723 patients included (mean age 75.5 ± 9.9 years; 52.4% male), 28.9% had delirium before or during GR admission. Participants with delirium recovered in ADL at approximately the same rate as those without (linear slope effect = -0.13, SE 0.16, P = .427) up to an estimated BI score of 16.1 at 6 months. Similarly, participants with delirium recovered in QoL at approximately the same rate as those without (linear slope effect = -0.017, SE 0.015, P = .248), up to an estimated EQ-5D-5L score of 0.8 at 6 months. CONCLUSIONS AND IMPLICATIONS: Presence of delirium during the acute phase of infection or subsequent GR did not influence the recovery trajectory of ADL functioning and QoL.
Department of Geriatric Medicine Beaumont Hospital Dublin Ireland
Department of Geriatrics Amphia Hospital Breda the Netherlands
Department of Health Services Research Maastricht University Maastricht The Netherlands
Department of Public Health and Primary Care Leiden University Medical Centre Leiden the Netherlands
Faculty of Health and Social Sciences South Bohemian University České Budějovice Czech Republic
Fliman Geriatric Rehabilitation Centre Haifa Israel
Geriatric Division Holy Family Hospital Bar Ilan University Safad Israel
IRCCS Istituti Clinici Maugeri University of Milan Milan Italy
LUMC Center for Medicine for Older People Leiden University Medical Center Leiden the Netherlands
Russian Clinical and Research Centre of Gerontology Moscow Russia
References provided by Crossref.org
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- $a OBJECTIVES: Delirium is common during acute infection in older patients and is associated with functional decline. Geriatric rehabilitation (GR) can help older patients to return to their premorbid functional level. It is unknown whether delirium affects GR outcomes in patients with acute infection. We evaluated whether delirium affects trajectories of activities of daily living (ADL) and quality of life (QoL) recovery in GR after COVID-19 infection. DESIGN: This study was part of the EU-COGER study, a multicenter cohort study conducted between October 2020 and October 2021. SETTING AND PARTICIPANTS: Participants were recruited after COVID-19 infection from 59 GR centers in 10 European countries. METHODS: Data were collected at GR admission, discharge, and at the 6-week and 6-month follow-ups. Trajectories of ADL [using the Barthel index (BI)] and QoL [using the EuroQol-5 Dimensions-5 Level (EQ-5D-5L)] recovery were examined using linear mixed models. RESULTS: Of the 723 patients included (mean age 75.5 ± 9.9 years; 52.4% male), 28.9% had delirium before or during GR admission. Participants with delirium recovered in ADL at approximately the same rate as those without (linear slope effect = -0.13, SE 0.16, P = .427) up to an estimated BI score of 16.1 at 6 months. Similarly, participants with delirium recovered in QoL at approximately the same rate as those without (linear slope effect = -0.017, SE 0.015, P = .248), up to an estimated EQ-5D-5L score of 0.8 at 6 months. CONCLUSIONS AND IMPLICATIONS: Presence of delirium during the acute phase of infection or subsequent GR did not influence the recovery trajectory of ADL functioning and QoL.
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