(056) Role of inpatient Rehabilitation in Managing Delirium: A Review

Background: Cognitive dysfunction including delirium is a common complication of inpatient and ICU admissions, especially affecting the elderly population. Delirium is associated with an increase in mortality, long-term cognitive impairments and reliance on long-term care, which necessitates researchers to address this issue, with the ulterior aim of reducing long term morbidity and healthcare costs. Our study plans to review the role of a rehabilitation team-based approach in the mitigation of delirium and other forms of cognitive dysfunction.

Methods: We did a review of 863 articles using specific MeSH terms “delirium”, “ICU”, “rehabilitation”, “Physical therapy” and
“occupational therapy” and “nonpharmacological treatment” from four electronic databases - PubMed, Embase, Scopus, and Google Scholar. We narrowed down our search to19 relevant articles which directly dealt with this topic.

Results: Multi component interventions including occupational therapy were found to be effective in the prevention and management of delirium in elderly individuals across various inpatients including ICUs. (2,3) Early cognitive rehabilitation training was found to significantly increase neurocognitive function in the acute care setting. Physical
therapy was found to have positive effect in mitigating the motor components of delirium and associated frailty in older patients. (4,5)

Conclusions: A multidisciplinary rehabilitation approach is beneficial for the prevention and management of delirium in the acute inpatient setting.

Reference:
1) León-Salas B, Trujillo-Martín MM, Martínez Del Castillo LP, et al. Multicomponent Interventions for the Prevention of Delirium
in Hospitalized Older People: A Meta-Analysis. J Am GeriatrSoc. 2020;68(12):2947-2954. doi:10.1111/jgs.16768
2) Siddiqi N, House AO, Holmes JD. Occurrence and outcome of delirium in medical in-patients: a systematic literature
review. Age Ageing. 2006;35(4):350-364.doi:10.1093/ageing/afl005
3) Tobar E, Alvarez E, Garrido M. Cognitive stimulation and occupational therapy for delirium prevention. Rev Bras Ter
Intensiva. 2017 Apr-Jun;29(2):248-252. doi: 10.5935/0103-507X.20170034. PMID: 28977265; PMCID: PMC5496760.
4) Martinez F, Tobar C, Hill N. Preventing delirium: should non-pharmacological, multicomponent interventions be used? A
systematic review and meta-analysis of the literature. Age Ageing. 2015;44(2):196-204. doi:10.1093/ageing/afu173
5) Gual N, García-Salmones M, Brítez L, Crespo N, Udina C,Pérez LM, Inzitari M. The role of physical exercise and
rehabilitation in delirium. Eur Geriatr Med. 2020 Feb;11(1):83-93. doi: 10.1007/s41999-020-00290-6. Epub 2020 Feb 17.
PMID: 32297245; PMCID: PMC7224129.