ACUTE DELIRIUM AND FUNCTIONAL DECLINE IN THE HOSPITALIZED ELDERLY PATIENT

Background. Delirium is often considered a transient cognitive syndrom e. Its effect on long-term physical function, however, has not been we ll defined. Methods. In a prospective study of 325 hospitalized commun ity and nursing home elderly, we analyzed the effect of in-hospital de lirium on subsequent physical function. ADL performance was assessed p rior to admission, and at 3 and 6 months after hospital discharge. Res ults. There was a strong univariate (unadjusted) association between i ncident delirium and functional decline (p < .02). Delirious subjects lost a mean of almost one ADL, as measured 3 months after hospital dis charge. Using multivariate linear regression analysis, with adjusted c hange in function as the dependent variable, delirium persisted as the sole predictor of loss of function (p = .009) at 3 months after disch arge. The functional decline persisted at 6 months after hospital disc harge. Conclusion. This finding of a nontransient, perhaps permanent c onsequence of delirium invites reexamination of the definition of deli rium from that of an acute, reversible syndrome to one of acute onset with long-term sequelae.