Objectives

Delirium is common during acute infection in older patients and is associated with functional decline. Geriatric rehabilitation (GR) can help older patients to return to their premorbid functional level. It is unknown whether delirium affects GR outcomes in patients with acute infection. We evaluated whether delirium affects trajectories of activities of daily living (ADL) and quality of life (QoL) recovery in GR after COVID-19 infection.

Design

This study was part of the EU-COGER study, a multicenter cohort study conducted between October 2020 and October 2021.

Setting and participants

Participants were recruited after COVID-19 infection from 59 GR centers in 10 European countries.

Methods

Data were collected at GR admission, discharge, and at the 6-week and 6-month follow-ups. Trajectories of ADL [using the Barthel index (BI)] and QoL [using the EuroQol-5 Dimensions-5 Level (EQ-5D-5L)] recovery were examined using linear mixed models.

Results

Of the 723 patients included (mean age 75.5 ± 9.9 years; 52.4% male), 28.9% had delirium before or during GR admission. Participants with delirium recovered in ADL at approximately the same rate as those without (linear slope effect = -0.13, SE 0.16, P = .427) up to an estimated BI score of 16.1 at 6 months. Similarly, participants with delirium recovered in QoL at approximately the same rate as those without (linear slope effect = -0.017, SE 0.015, P = .248), up to an estimated EQ-5D-5L score of 0.8 at 6 months.

Conclusions and implications

Presence of delirium during the acute phase of infection or subsequent GR did not influence the recovery trajectory of ADL functioning and QoL.

Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

Overview publication

TitleThe Impact of Delirium on Recovery in Geriatric Rehabilitation after Acute Infection.
DateAugust 1st, 2024
Issue nameJournal of the American Medical Directors Association
Issue numberv25.8:105002
DOI10.1016/j.jamda.2024.03.113
PubMed38670170
AuthorsMinnema J, Polinder-Bos HA, Cesari M, Dockery F, Everink IHJ, Francis BN, Gordon AL, Grund S, Perez Bazan LM, Eruslanova K, Topinková E, Vassallo MA, Faes MC, van Tol LS, Caljouw MAA, Achterberg WP & Haaksma ML
KeywordsADL, COVID-19, Delirium, Geriatric rehabilitation, Older adults, QoL, Recovery
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