Identifying Risk Factors for Delirium Through Comprehensive Geriatric Assessment in Older Adults Receiving Palliative Cancer Care

<b>Background/Objectives</b>: Older adults with cancer are at high risk of developing delirium. Comprehensive geriatric assessment (CGA) is a fundamental tool for prioritizing problems and establishing appropriate interventions in older patients. This study aimed to identify risk factors for delirium through a CGA in older adults receiving palliative cancer care in hospital. <b>Methods</b>: This longitudinal observational study included people aged 65 years or over who were hospitalized in medical wards with an advanced stage of cancer. Clinicians performed a CGA and screened for delirium using the Confusion Assessment Method (CAM). Diagnosis of delirium was based on criteria set out in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). We calculated odds ratios (ORs) with 95% confidence intervals (CIs) to compare different variables in people with versus without delirium. <b>Results</b>: The study included 105 participants, of whom 67 (63.81%) developed delirium during follow-up. The mean age was 71.33 years in the delirium group and 72.24 years in the non-delirium group. Risk factors for delirium were dysphagia (OR 2.45, 95% CI 1.01-5.99; <i>p</i> = 0.045), urinary catheterization (OR 2.97, 95% CI 1.09-8.13; <i>p</i> = 0.029), and having at least one delirium episode in the last year (OR 5.68, 95% CI 1.97-16.34; <i>p</i> = 0.001). The predictive model showed that older male cancer patients with a urinary catheter and dysphagia are most likely to develop delirium in hospital (area under the curve [AUC] = 0.679, 95% CI 0.577-0.780; <i>p</i> = 0.002). <b>Conclusions</b>: The prevention and effective management of delirium require a person-centered, interdisciplinary approach that considers both clinical and psychosocial aspects. Including variables such as male sex, dysphagia, and urinary catheterization in delirium risk assessment enables more comprehensive and personalized management.

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Publication Details

Journal
Nursing Reports
Published
2025-09-08
DOI
https://doi.org/10.3390/nursrep15090328
Primary Topic
Intensive Care Unit Cognitive Disorders
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article
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article

Identifying Risk Factors for Delirium Through Comprehensive Geriatric Assessment in Older Adults Receiving Palliative Cancer Care

Francisco Miguel Martínez‐Arnau, Pilar Pérez‐Ros, Paula Llisterri-Sánchez
Nursing Reports
Intensive Care Unit Cognitive Disorders
article

Identifying Risk Factors for Delirium Through Comprehensive Geriatric Assessment in Older Adults Receiving Palliative Cancer Care

Francisco Miguel Martínez‐Arnau, Pilar Pérez‐Ros, Paula Llisterri-Sánchez
article en

Abstract

<b>Background/Objectives</b>: Older adults with cancer are at high risk of developing delirium. Comprehensive geriatric assessment (CGA) is a fundamental tool for prioritizing problems and establishing appropriate interventions in older patients. This study aimed to identify risk factors for delirium through a CGA in older adults receiving palliative cancer care in hospital. <b>Methods</b>: This longitudinal observational study included people aged 65 years or over who were hospitalized in medical wards with an advanced stage of cancer. Clinicians performed a CGA and screened for delirium using the Confusion Assessment Method (CAM). Diagnosis of delirium was based on criteria set out in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). We calculated odds ratios (ORs) with 95% confidence intervals (CIs) to compare different variables in people with versus without delirium. <b>Results</b>: The study included 105 participants, of whom 67 (63.81%) developed delirium during follow-up. The mean age was 71.33 years in the delirium group and 72.24 years in the non-delirium group. Risk factors for delirium were dysphagia (OR 2.45, 95% CI 1.01-5.99; <i>p</i> = 0.045), urinary catheterization (OR 2.97, 95% CI 1.09-8.13; <i>p</i> = 0.029), and having at least one delirium episode in the last year (OR 5.68, 95% CI 1.97-16.34; <i>p</i> = 0.001). The predictive model showed that older male cancer patients with a urinary catheter and dysphagia are most likely to develop delirium in hospital (area under the curve [AUC] = 0.679, 95% CI 0.577-0.780; <i>p</i> = 0.002). <b>Conclusions</b>: The prevention and effective management of delirium require a person-centered, interdisciplinary approach that considers both clinical and psychosocial aspects. Including variables such as male sex, dysphagia, and urinary catheterization in delirium risk assessment enables more comprehensive and personalized management.

Nursing ReportsVol. 15(9)
Universitat de València (ES), Valencia Catholic University Saint Vincent Martyr (ES), Menéndez Pelayo International University (ES)
Openalex Percentile: Top 71%
Intensive Care Unit Cognitive Disorders
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