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PREVALENCE OF DELIRIUM IN OLDER HOSPITALISED ADULTS IN TANZANIA. THE IDEA (IDENTIFICATION AND INTERVENTIONS FOR DEMENTIA IN ELDERLY AFRICANS) STUDY
  1. S-M Paddick1,2,
  2. WK Gray2,
  3. C Dotchin2,
  4. A Kisoli3,5,
  5. G Mbowe4,5,
  6. J Kisima3,
  7. F Lwezaula4,
  8. S Mkenda5,
  9. D Mushi5,
  10. A Teodorczuk1,
  11. A Ogunniyi7,
  12. R Walker2,8
  1. 1Institute of Neuroscience, Newcastle University, UK
  2. 2Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
  3. 3Hai District Hospital, Boma'ngombe. Kilimanjaro, Tanzania
  4. 4Mawenzi Regional Hospital, Kilimanjaro, Tanzania
  5. 5Tumaini University, Kilimanjaro Christian Medical College, Tanzania
  6. 6Kilimanjaro Christian Medical Centre, Tanzania
  7. 7University College Hospital, University of Ibadan, Ibadan, Nigeria
  8. 8Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK

Abstract

Objective In sub-Saharan Africa (SSA), little is currently known of the prevalence or causes of delirium. To date, only one study has reported prevalence in older adults in SSA, despite the known vulnerability of this group to delirium and the associated adverse outcomes. Validated screening tools are also lacking. We aimed to identify the prevalence of delirium in 100 new inpatient medical admissions aged 65 and over in a public hospital in Tanzania.

Method Participants were screened for cognitive impairment using the IDEA brief cognitive screening tool, previously validated for dementia in SSA. All participants were subsequently assessed by a research doctor. This assessment included the Confusion Assessment Method (CAM) alongside cognitive assessment, neurological examination and informant history. DSM-IV and ICD-10 criteria were used for dementia and delirium diagnosis

Results Three patients were excluded because they did not fully complete the assessment before discharge. Of the remaining 97 patients, 17 (17.53%) met criteria for delirium when assessed. Of these, 10 (10.31%) had a history suggestive of dementia with superimposed delirium.

Conclusion Delirium was common in this group of hospitalised older adults in Tanzania, but prevalence was lower than that reported in high income country studies. Our prevalence estimate of delirium may be a conservative one, since patients were assessed only once during hospital admission. The IDEA screening tool appeared effective in identifying delirium in this group and further validation is suggested.

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