Association of Delirium and Physical Function to Cognitively Stimulating Activities in Patients with Delirium Superimposed on Dementia
Open Access
- Author:
- Prater, Emily Regina
- Area of Honors:
- Nursing
- Degree:
- Bachelor of Science
- Document Type:
- Thesis
- Thesis Supervisors:
- Harleah Graham Buck, Thesis Supervisor
Harleah Graham Buck, Thesis Honors Advisor
Ying-Ling Jao, Faculty Reader - Keywords:
- delirium superimposed on dementia
activities
delirium
physical function - Abstract:
- Background: Delirium superimposed on dementia (DSD) occurs when an individual with a pre-existing dementia develops delirium. Delirium, a state of confusion with acute onset and fluctuating course, is common and deadly in older adults with dementia. There is no widely accepted intervention for delirium, but preliminary evidence indicates that cognitive stimulation may hold promise for resolving some of the cognitive impairments associated with delirium. In this study, we were interested in determining factors, functional status and delirium in the presence of dementia, that are associated with the ability of patients with DSD to engage in cognitive activities. Purpose: To assess the association of delirium and functional status in the presence of dementia to the ability of patients with DSD in post-acute care to engage in cognitively stimulating activities in each cognitive domain Methods: This study is a secondary analysis of a randomized clinical trial testing the effect of interventions in people with DSD. The present study included 141 participants of the intervention group. Each participant received a daily 30-minute session of recreational activities for up to 30 days. The activities involved five cognitive domains and were tailored based on individuals’ interest. Data on participants’ level of delirium, level of physical function, and level of activity engagement were collected. Descriptive statistics and bivariate correlations were used to examine the association of delirium and physical function to the engagement of activities completed in each cognitive domain respectively. Results: Participants were 85 years of age on average and predominantly white (96.5%). They had mild to moderate delirium and poor physical function. A small negative, yet statistically significant relationship between delirium and the number of activities attempted was found (r= -0.22, p< 0.0001); however, physical function and number of activities attempted are not significantly related in this sample. Conclusion and Implications: This study revealed that level of delirium is associated with engagement of cognitively stimulating activities – the more severe the delirium, the less activity engagement. However, the level of physical function was not found to be associated with activity engagement. These findings will help guide intervention design for people with DSD. Specifically, interventions for DSD may need to be tailored based on individuals’ severity of delirium. Individuals’ physical function does not impede their capacity to carry out cognitively stimulating activities.