Bob DeMarco Alzheimer's Reading Room

Thursday, June 9, 2011

Methods of Relieving Delirium In Dementia Patients the Focus of NIH grant


Delirium, defined as a state of mental confusion, occurs in more than half of all hospitalized older adults who have dementia. If delirium continues, it can interfere with patient rehabilitation and there is a very high risk of permanent institutionalization.

Alzheimer's Reading Room

This NIH grant should be of great interest to many Alzheimer's and dementia caregivers. I know of many examples where Alzheimer's patients suffered with bouts of delirium as a result of urinary tract infections. This can be very disheartening.

The fact that this can lead to permanent institutionalization indicates how important this study could be for the Alzheimer's community.

Like the study and article we obtained on dental care from Rita Jablonski, this research is being done at my alma mater Penn State. I intend to contact Ann Kolanowski at Penn State to see if we can get some insight, advice, and tips to on how to deal with delirium.


Methods of relieving delirium are the focus of $2.4 million NIH grant

Adults with dementia and delirium may soon have a way to combat their delirium, thanks to a five-year, $2.4 million grant from the National Institutes of Health.

Delirium, defined as a state of mental confusion, occurs in more than half of all hospitalized older adults who have dementia. If delirium continues, it can interfere with patient rehabilitation and there is a very high risk of permanent institutionalization.

Ann Kolanowski
"Delirium is prevalent in people with dementia," said Ann Kolanowski, Elouise Ross Eberly professor of nursing at Penn State. "We found in our pilot study that many older adults who have dementia and experience a medical problem often develop delirium, and it doesn't necessarily resolve by the time they are discharged from the hospital."

The grant, from NIH's National Institute of Nursing Research, was awarded to Kolanowski and colleague Donna Fick, professor of nursing at Penn State. The researchers will test an intervention consisting of cognitive activities to help people who suffer from delirium superimposed on dementia.

"Cognitive processing helps restore cognitive functioning," said Kolanowski. "In delirium, improved cognitive function is accompanied by improvement in physical function and resolution of delirium."

The intervention Kolanowski and colleagues propose is called Recreational Stimulation for Elders as a Vehicle to Resolve Delirium Superimposed on Dementia. It is a drug-free intervention that focuses on simple, but intellectually stimulating, recreational tasks. Each task focuses on different cognitive domains, which include memory, attention, orientation, abstract thinking and executive functioning.
"One of the more popular activities is 'finish the phrase,'" said Kolanowski, explaining a memory exercise. "So we might say something like, 'every Tom, Dick and …' and let them finish with 'Harry.' Or 'a bird in the hand is worth …' and they'd say 'two in a bush.'"

In addition to Kolanowski and Fick, other researchers on the grant include Paula Mulhall, project director, Penn State; Douglas Leslie, professor in public health sciences, Penn State College of Medicine; Linda Clare, professor of clinical psychology and neuropsychology, Bangor University; Mark Litaker, associate professor in general dental sciences and director of biostatistics, University of Alabama at Birmingham; Malaz Boustani, associate professor of medicine, Indiana University; and Keith Whitfield, professor of psychology and neuroscience, Duke University.

http://live.psu.edu/story/53571#nw3



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