Impact of income levels on the prevalence of delirium: A secondary analysis of the World Delirium Awareness and Quality Survey in 2023

Background Delirium is associated with functional decline and reduced quality of life. While multiple risk factors have been identified, the relationship between national income level and delirium prevalence remains unclear. Aim To examine the association between country income level and delirium prevalence. Methods We performed a secondary analysis of the World Delirium Awareness and Quality Survey (WDAD2023), a one-day international cross-sectional epidemiological study. Delirium prevalence was assessed twice daily in wards or ICUs and compared between high-income and non-high-income countries. The primary outcome was median ward/unit delirium prevalence. Secondary outcomes included differences in delirium management practices. Multivariable analyses were conducted to adjust for these factors. Results Of 1,664 responses, 1,344 were analysed. Non-high-income countries included 159 facilities in 17 countries, and high-income countries included 1,185 facilities in 24 countries. Median ward/unit delirium prevalence was higher in non-high-income countries both in the morning (16.7% vs 11.1%, p < 0.01) and evening (20.0% vs 11.1%, p < 0.01). Management practices differed significantly between groups. In exploratory multivariable analyses, non-high-income status was associated with higher delirium prevalence after adjustment for potential confounding factors (p < 0.01). Conclusions and Relevance: Country income level might be associated with delirium prevalence. The development of specific delirium protocols for countries with low resources should be considered and evaluated.

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Journal
Delirium
Published
2026-11-02
DOI
https://doi.org/10.56392/001c.172480
Primary Topic
Intensive Care Unit Cognitive Disorders
Type
article
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article

Impact of income levels on the prevalence of delirium: A secondary analysis of the World Delirium Awareness and Quality Survey in 2023

Gideon A. Caplan, Heidi L. Lindroth, Nobuto Nakanishi, Chi Ryang Chung et al.
4 links
Delirium
Intensive Care Unit Cognitive Disorders
article

Impact of income levels on the prevalence of delirium: A secondary analysis of the World Delirium Awareness and Quality Survey in 2023

Gideon A. Caplan, Heidi L. Lindroth, Nobuto Nakanishi, Chi Ryang Chung, Julie Sarah Benbenishty, Magdalena M. Hoffmann, Alessandro Morandi, Peter Nydahl, Maria Carolina Paulino, Gabriel Heras La Calle, Giuseppe Bellelli, Esther S. Oh, Rebecca von Haken, Muhammed Elhadi, Karla D. Krewulak, Ricardo Kenji Nawa, Mohan Gurjar, Shigeaki Inoue, Keibun Liu, Marie‐Madlen Jeitziner, Tanya Mailhot, Kensuke Nakamura, Mark van den Boogaard, Marie Oxenbøll Collet, Kyohei Miyamaoto
article en

Abstract

Background Delirium is associated with functional decline and reduced quality of life. While multiple risk factors have been identified, the relationship between national income level and delirium prevalence remains unclear. Aim To examine the association between country income level and delirium prevalence. Methods We performed a secondary analysis of the World Delirium Awareness and Quality Survey (WDAD2023), a one-day international cross-sectional epidemiological study. Delirium prevalence was assessed twice daily in wards or ICUs and compared between high-income and non-high-income countries. The primary outcome was median ward/unit delirium prevalence. Secondary outcomes included differences in delirium management practices. Multivariable analyses were conducted to adjust for these factors. Results Of 1,664 responses, 1,344 were analysed. Non-high-income countries included 159 facilities in 17 countries, and high-income countries included 1,185 facilities in 24 countries. Median ward/unit delirium prevalence was higher in non-high-income countries both in the morning (16.7% vs 11.1%, p < 0.01) and evening (20.0% vs 11.1%, p < 0.01). Management practices differed significantly between groups. In exploratory multivariable analyses, non-high-income status was associated with higher delirium prevalence after adjustment for potential confounding factors (p < 0.01). Conclusions and Relevance: Country income level might be associated with delirium prevalence. The development of specific delirium protocols for countries with low resources should be considered and evaluated.

Delirium
Hiroshima University (JP), University of Bern (CH), University of Copenhagen (DK), Alberta Health Services (CA), Mayo Clinic (US), University of Lisbon (PT), Johns Hopkins University (US), Radboud University Nijmegen (NL), Sanjay Gandhi Post Graduate Institute of Medical Sciences (IN), University of Calgary (CA), University of Basel (CH), Wakayama Medical University (JP), Hebrew University of Jerusalem (IL), Medical University of Graz (AT), University of Tripoli (LY), Paracelsus Medical University (AT), Johns Hopkins Medicine (US), Hospital Israelita Albert Einstein (BR), University Hospital of Bern (CH), Samsung Medical Center (KR), Copenhagen University Hospital (DK), Radboud University Medical Center (NL), UNSW Sydney (AU), Kobe University Hospital (JP), Yokohama City University Hospital (JP), Prince of Wales Hospital (AU), Azienda Ospedaliera San Gerardo (IT), University Hospital Schleswig-Holstein (DE), Prince of Wales Hospital (CN), Complejo Hospitalario de Jaén (ES), Hiroshima University Hospital (JP), Prince Charles Hospital (AU), Hospital da Luz (PT), University Medical Centre Mannheim (DE), Prince Charles Hospital (GB), Indiana University Indianapolis (US), Indiana University School of Medicine (US), Wakayama Medical University Hospital (JP), Kobe University (JP), University of Milano-Bicocca (IT), Université de Montréal (CA), Sungkyunkwan University (KR), Yokohama City University (JP)
Good health and well-being, Reduced inequalities
Openalex Percentile: Top 100%
Intensive Care Unit Cognitive Disorders
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