The PREvention Program for Alzheimer's RElated Delirium (PREPARED) cluster randomized trial: a study protocol.

Background: Delirium is a significant cause of morbidity and mortality among older people admitted to both acute and long-term care facilities (LTCFs). Multicomponent interventions have been shown to reduce delirium incidence in the acute care setting (30-73%) by acting on modifiable risk factors. Little work, however, has focused on using this approach to reduce delirium incidence in LTCFs.

Pilot Study of a Transitional Intervention for Family Caregivers of Older Adults.

Objectif: Évaluation (faisabilité, acceptabilité, pertinence et bienfaits potentiels) d'une intervention de transition pour proches aidants. Méthode: L'intervention visait à fournir du soutien émotionnel, de l'information sur les ressources communautaires et du soutien au développement des capacités d'adaptation pour les proches aidants de patients de 65 ans et plus qui avaient reçu leur congé suite à une hospitalisation de courte durée. L'approche méthodologique a impliqué un seul groupe, qui a été évalué lors d'un pré-test et d'un post-test effectué trois mois après le début de l'intervention.

Latent class analysis of the multivariate Delirium Index in long-term care settings.

Unlabelled: ABSTRACTBackground:A few studies examine the time evolution of delirium in long-term care (LTC) settings. In this work, we analyze the multivariate Delirium Index (DI) time evolution in LTC settings.

Methods: The multivariate DI was measured weekly for six months in seven LTC facilities, located in Montreal and Quebec City.

Partial and no recovery from delirium after hospital discharge predict increased adverse events.

Background: The implications of partial and no recovery from delirium after hospital discharge are not clear. We sought to explore whether partial and no recovery from delirium among recently discharged patients predicted increased adverse events (emergency room visits, hospitalisations, death) during the subsequent 3 months.

Method: Prospective study of recovery from delirium in older hospital inpatients.

Association Between Chronic Physical Conditions and the Effectiveness of Collaborative Care for Depression: An Individual Participant Data Meta-analysis.

Importance: Collaborative care is an intensive care model involving several health care professionals working together, typically a physician, a case manager, and a mental health professional. Meta-analyses of aggregate data have shown that collaborative care is particularly effective in people with depression and comorbid chronic physical conditions. However, only participant-level analyses can rigorously test whether the treatment effect is influenced by participant characteristics, such as chronic physical conditions.

Longitudinal patterns of delirium severity scores in long-term care settings.

Background: The delirium index (DI) is a valid measure of delirium severity. We proposed to describe longitudinal patterns of severity scores in older long-term care (LTC) residents.

Methods: A prospective cohort study of 280 residents in seven LTC facilities in Montreal and Quebec City, Canada, was conducted.

Delirium in older adults: a chronic cognitive disorder?

Delirium is defined as a neurocognitive disorder characterized by sudden onset, fluctuating course, and disturbances in level of consciousness, attention, orientation, memory, thought, perception, and behavior (American Psychiatric Association, 2013). It occurs in hyperactive, hypoactive, or mixed forms in up to 50% of older hospital patients (Inouye et al., 2014) and 70% of older long-term care residents (McCusker et al.

Activation and Self-Efficacy in a Randomized Trial of a Depression Self-Care Intervention.

Objectives: In a sample of primary care participants with chronic physical conditions and comorbid depressive symptoms: to describe the cross-sectional and longitudinal associations of activation and self-efficacy with demographic, physical and mental health status, health behaviors, depression self-care, health care utilization, and use of self-care tools; and to examine the effects of a depression self-care coaching intervention on these two outcomes. Design/Study Setting. A secondary analysis of activation and self-efficacy data collected as part of a randomized trial to compare the effects of a telephone-based coached depression self-care intervention with a noncoached intervention.

A randomized trial of a depression self-care toolkit with or without lay telephone coaching for primary care patients with chronic physical conditions.

Objective: The aim of this study was to compare outcomes of use of a depression self-care toolkit with and without lay telephone coaching among primary care patients 40 years and older with depressive symptoms and comorbid chronic physical conditions.

Method: A single blind, individually randomized, pragmatic trial of a depression self-care toolkit (Toolkit) with or without lay telephone coaching was conducted among primary care adults with depressive symptoms and comorbid chronic physical conditions. Eligible patients were randomized to receive the Toolkit with (intervention) or without (control) telephone coaching provided by trained lay coaches.

Use of medications that antagonize mediators of inflammatory responses may reduce the risk of delirium in older adults: a nested case-control study.

Objective: The objective of this study is to explore whether the use of medications that antagonize mediators of inflammatory responses reduces the risk of delirium in older adults.

Methods: A nested case-control study was conducted using data from a prospective study of delirium in older long-term care residents from 7 long-term care facilities in Montreal and Quebec City, Canada. The Confusion Assessment Method was used to diagnose incident delirium.

Frequency of full, partial and no recovery from subsyndromal deliriumin older hospital inpatients.

Objectives: To determine the frequencies of full, partial and no recovery from subsyndromal delirium (SSD) in older hospital inpatients. A secondary objective was to compare the recovery status of patients with SSD or delirium.

Methods: SSD was defined as acute onset of one or more Confusion Assessment Method core symptoms of delirium (fluctuation, inattention, disorganized thinking and altered level of consciousness) not meeting criteria for delirium and not progressing to delirium.

Partial and No Recovery from Delirium in Older Hospitalized Adults: Frequency and Baseline Risk Factors.

Objectives: To determine the frequency and baseline risk factors for partial and no recovery from delirium in older hospitalized adults.

Design: Cohort study with assessment of recovery status approximately 1 and 3 months after enrollment.

Setting: University-affiliated, primary, acute-care hospital.

Six-month trajectories of self-reported depressive symptoms in long-term care.

Background: Depression is a common problem in long-term care (LTC) settings. We sought to characterize depression symptom trajectories over six months among older residents, and to identify resident characteristics at baseline that predict symptom trajectory.

Methods: This study was a secondary analysis of data from a six-month prospective, observational, and multi-site study.

A randomized trial of a depression self-care toolkit with or without lay telephone coaching for primary care patients with chronic physical conditions.

Objective: The aim of this study was to compare outcomes of use of a depression self-care toolkit with and without lay telephone coaching among primary care patients 40 years and older with depressive symptoms and comorbid chronic physical conditions.

Method: A single blind, individually randomized, pragmatic trial of a depression self-care toolkit (Toolkit) with or without lay telephone coaching was conducted among primary care adults with depressive symptoms and comorbid chronic physical conditions. Eligible patients were randomized to receive the Toolkit with (intervention) or without (control) telephone coaching provided by trained lay coaches.

Six-month outcomes of co-occurring delirium, depression, and dementia in long-term care.

Objectives: To describe the 6-month outcomes of co-occurring delirium (full syndrome and subsyndromal symptoms), depression, and dementia in a long-term care (LTC) population.

Design: Observational, prospective cohort study with 6-month follow-up conducted from 2005 to 2009.

Setting: Seven LTC facilities in the province of Quebec, Canada.

Behavioral and psychological symptoms of dementia: how long does every behavior last, and are particular behaviors associated with PRN antipsychotic agent use?

Behavioral and psychological symptoms of dementia (BPSD) affect approximately all residents in nursing homes at some point; however, the course of BPSD among this group is not well known. The goal of the current study was to describe the course of each measured BPSD over a period of 6 months. A secondary explorative objective was to identify which BPSD are associated with as-needed (PRN) antipsychotic drug use.

Core symptoms not meeting criteria for delirium are associated with cognitive and functional impairment and mood and behavior problems in older long-term care residents.

Background: The immediate clinical significance of Confusion Assessment Method (CAM)-defined core symptoms of delirium not meeting criteria for delirium is unclear. This study proposed to determine if such symptoms are associated with cognitive and functional impairment, mood and behavior problems and increased Burden of Care (BOC) in older long-term care (LTC) residents.

Methods: The study was a secondary analysis of data collected for a prospective cohort study of delirium.

Observer-rated depression in long-term care: frequency and risk factors.

The objectives of this study were: (1) to describe the prevalence and 6-month incidence of observer-rated depression in residents age 65 and over of long-term care (LTC) facilities; (2) to describe risk factors for depression, at baseline and over time. A multisite, prospective observational study was conducted in residents aged 65 and over of 7 LTC facilities. The Cornell Scale for Depression in Dementia (CSDD) was completed by nurses monthly for 6 months.

Feasibility and acceptability of a delirium prevention program for cognitively impaired long term care residents: a participatory approach.

In this participatory action research study, researchers conducted a total of 3 implementation cycles to evaluate the feasibility and acceptability of a new delirium prevention program (DPP) for cognitively impaired residents in long term care (LTC) settings. Researchers interviewed 95 health care staff to obtain feedback on their use of the DPP and then modified the DPP and tested the changes in the next implementation cycle. Our results indicated that the DPP was feasible and that health care staff would accept it under certain conditions.

Environmental factors predict the severity of delirium symptoms in long-term care residents with and without delirium.

Objectives: To identify potentially modifiable environmental factors (including number of medications) associated with changes over time in the severity of delirium symptoms and to explore the interactions between these factors and resident baseline vulnerability.

Design: Prospective, observational cohort study.

Setting: Seven long-term care (LTC) facilities.

Symptoms of delirium predict incident delirium in older long-term care residents.

Background: Detection of long-term care (LTC) residents at risk of delirium may lead to prevention of this disorder. The primary objective of this study was to determine if the presence of one or more Confusion Assessment Method (CAM) core symptoms of delirium at baseline assessment predicts incident delirium. Secondary objectives were to determine if the number or the type of symptoms predict incident delirium.