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Age and Ageing Advance Access originally published online on May 21, 2009
Age and Ageing 2009 38(4):374-379; doi:10.1093/ageing/afp039
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© The Author 2009. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Review

Non-pharmacological interventions in the prevention of delirium

Naji Tabet1 and Robert Howard2

1 Institute of Postgraduate Medicine, Brighton & Sussex Medical School, University of Brighton, Falmer, Brighton BN1 9PH, UK and Cognitive Treatment and Research Unit, Sussex Partnership NHS Foundation Trust, UK
2 Institute of Psychiatry, DeCespingy Park, London SE5 8AF, UK

Address correspondence to: N. Tabet. Tel: (+44) (0)1273 644503. Email: n.t.tabet{at}brighton.ac.uk

Delirium is a serious and common disorder especially among older people on inpatients units. Numerous modifiable or manageable delirium risk factors have been identified. As a result, there is now a widespread notion that many cases of delirium can be prevented. In this review, published data evaluating non-pharmacological interventions for delirium prevention were assessed in relation to their efficacy. Currently, most published studies are based on direct targeting of risk factors and/or introduction of educational programmes to increase staff knowledge and awareness. However, there continues to be a dearth of randomised controlled trials evaluating non-pharmacological interventions, partly because of the inherent difficulties associated with delirium research in general and with the evaluation of non-pharmacological interventions in particular. Instead, many of the available studies have been observational or non-randomised in nature. Nevertheless, the majority of these support a role for non-pharmacological interventions in delirium prevention. While more research is certainly needed, the majority of available data are based on best practice protocols, guidelines and interventions. Hence, a consistent and concerted effort is now justified to introduce non-pharmacological prevention strategies across units to help tackle the increasingly prevalent delirium among older people.

Keywords: non-pharmacological, delirium, intervention, prevention, older people, elderly

Received 10 October 2008; accepted in revised form 13 March 2009.


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