Abstract
Background Delirium affects 25% of older inpatients and is associated with long-term cognitive impairment and future dementia. However, no population studies have systematically ascertained cognitive function before, cognitive deficits during, and cognitive impairment after delirium. Therefore, there is a need to address the following question: does delirium, and its features (including severity, duration, and presumed aetiologies), predict long-term cognitive impairment, independent of cognitive impairment at baseline?
Methods The Delirium and Population Health Informatics Cohort (DELPHIC) study is an observational population-based cohort study based in the London Borough of Camden. It is recruiting 2000 individuals aged ≥70 years and prospectively following them for two years, including daily ascertainment of all inpatient episodes for delirium. Daily inpatient assessments include the Memorial Delirium Assessment Scale, the Observational Scale for Level of Arousal, and the Hierarchical Assessment of Balance and Mobility. Data on delirium aetiology is also collected. The primary outcome is the change in the modified Telephone Interview for Cognitive Status at two years.
Discussion DELPHIC is the first population sample to assess older persons before, during and after hospitalisation. The cumulative incidence of delirium in the general population aged ≥70 will be described. DELPHIC offers the opportunity to quantify the impact of delirium on cognitive and functional outcomes. Overall, DELPHIC will provide a real-time public health observatory whereby information from primary, secondary, intermediate and social care can be integrated to understand how acute illness is linked to health and social care outcomes.
Footnotes
daniel.davis{at}ucl.ac.uk, sarah.richardson1{at}newcastle.ac.uk, j.hornby{at}ucl.ac.uk, h.bowden{at}ucl.ac.uk, k.hoffmann{at}ucl.ac.uk, maryse.weston-clarke{at}ucl.ac.uk, f.green{at}ucl.ac.uk, n.chaturvedi{at}ucl.ac.uk, alun.hughes{at}ucl.ac.uk, d.kuh{at}ucl.ac.uk, e.sampson{at}ucl.ac.uk, ruth.mizoguchi{at}nhs.net, khailee.cheah{at}nhs.net, melanieromain{at}nhs.net, abhi.sinha{at}nhs.net, rodricjenkin{at}nhs.net, cb105{at}medschl.cam.ac.uk, a.maclullich{at}ed.ac.uk
Abbreviations
- APACHE II
- Acute Physiological and Chronic Health Evaluation
- DELPHIC
- Delirium and Population Health Informatics Cohort
- DSM-IV
- Diagnostic and Statistical Manual, 4th edition
- I-AGeD
- Informant Assessment for Geriatric Delirium
- LINKAGE-Camden
- Long-term Information and Knowledge for Ageing in Camden
- MDAS
- Memorial Delirium Assessment Scale
- NEWS
- National Early Warning Score
- RFH
- Royal Free Hospital
- TICS-m
- Telephone Interview for Cognitive Status - modified
- UCH
- University College Hospital