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Confusional states 4Ds: Delirium, Dementia, Depression & Dignity
Listed below is the high level evidence on Confusional states 4Ds: Delirium, Dementia, Depression & Dignity produced by NICE, SIGN and NHS based organisations. Also included are the European Society guidelines where available. This list is produced and maintained by HEFT Library Services to support VITAL 4 Medics core skills programme developed in the Trust.
HEFT Local Policies
Acute confusional state confusion elderly sedation geriatric delirium assessment
Dr P Wallis, HEFT 01/03/2006. Next review date?
Map of Medicine
Delirium (acute confusional state)
Dementia – assessment
Depression - severe and complex
Depression - moderate to severe
Depression - mild to moderate
Dignity
End of life care in adults - care in the last days of life
National Guidelines & Non-UK Guidelines (includes Professional Bodies/Associations)
Delirium
Delirium: Evidence Update April 2012
A summary of selected new evidence relevant to NICE CG103 ‘Delirium: diagnosis, prevention and management’ (2010)
https://www.evidence.nhs.uk/topic/delirium
Delirium: diagnosis, prevention and management
NICE Clinical Guideline CG103 July 2010
https://www.evidence.nhs.uk/topic/delirium
Intervention Protocol
Annette M Britton, Jonathon Hogan-Doran, Najma Siddiqi
Multidisciplinary Team Interventions for the management of delirium in hospitalized patients
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005995/abstract
Interventional Review
Annette M Britton, Robert Russell
Multidisciplinary team interventions for delirium in patients with chronic cognitive impairment
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000395.pub3/abstract
Dementia
CG42 Dementia: Supporting people with dementia and their carers in health
and social care
http://publications.nice.org.uk/dementia-cg42
CG42 Dementia: audit support (update) 03 April 2009
http://guidance.nice.org.uk/index.jsp?action=download&o=43727
Dementia Pathway
http://pathways.nice.org.uk/pathways/dementia
Depression
CG90 Depression in adults: The treatment and management of depression in
adults
http://publications.nice.org.uk/depression-in-adults-cg90
Depression Pathway
http://pathways.nice.org.uk/pathways/depression
Dignity
Empathy, dignity and respect
Systematic Reviews – Cochrane Library
Delirium
Interventions for preventing delirium in hospitalised patients
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005563.pub2/abstract
Jackson KC, Lipman, AG
Drug therapy for delirium in terminally ill adult patients: October 2009
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004770/abstract
Dementia
Sydenham E, Dangour AD, Lim WS
Omega 3 fatty acid for the prevention of cognitive decline and dementia (Review) 13 June 2012
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005379.pub3/pdf
Depression
Intervention Review
Maree L Hackett, Craig S Anderson, Allan House, Jun Xia
Interventions for treating depression after stroke
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003437.pub3/abstract
Dignity
Chochinov HM, Kristjanson LJ, Breitbart W, McClement S, Hack TF, Hassard T, Harlos M
Effect of dignity therapy on distress and end-of-life experience in terminally ill patients: a randomised controlled trial.
Lancet Oncol. 2011 Aug;12(8):753-62. Epub 2011 Jul 6.
http://www.ncbi.nlm.nih.gov/pubmed/21741309
NHS Evidence
Confusional States
Lorenzl S, Füsgen I, Noachtar S.
Acute confusional states in the elderly-diagnosis and treatment.
Deutsches Arzteblatt Int.ernational 2012 May;109(21):p 391-400.
Epub 2012 May 25
Insel KC, Badger TA.
Deciphering the 4 D's: cognitive decline, delirium, depression and dementia—a review.
Journal of Advanced Nursing: 2002; 38(4): p 360-368.
Andersson EM, Hallberg IR, Norberg A, Edberg AK.
The meaning of acute confusional state from the perspective of elderly patients.
International Journal of Geriatric Psychiatry. 2002 Jul;17(7) p 652-63.
Gustafson, Yngve; Brännström, Benny; Berggren, Diana; Ragnarsson, Jón I
A geriatric-anesthesiologic program to reduce acute confusional states in elderly patients treated for femoral neck fractures.
Journal of the American Geriatrics Society, Jul 1991, Vol 39(7) p 655-662.
Gustafson Y, Brännström B, Norberg A, Bucht G, Winblad B.
Underdiagnosis and poor documentation of acute confusional states in elderly hip fracture patients.
Journal of American Geriatric Society: 1991, August 39(8) p 760-5
Gustafson, Y.; Berggren, D.; Brännström, B.; Bucht, G
Acute confusional states in elderly patients treated for femoral neck fracture.
Journal of the American Geriatrics Society, Vol. 36(6), Jun 1988, 525-530.
William, MA
Predictors of acute confusional states in hospitalized elderly patients
Research in Nursing & Health, March 1985, Vol 8,(1) pages 31–40,
S Saeed, O Farooqi, B Panayiotou, and T Harvey
Reversible confusional state in an elderly man
Postrgaduate Medical Journal, 75(884) p 365-367
Delirium
Holroyd-Leduc JM, Khandwala F, Sink KM
How can delirium best be prevented and managed in older patients in hospital?
CMAJ. 2010 Mar 23; 182(5) p 465-70. Epub 2009 Aug 17.
http://www.crd.york.ac.uk/crdweb/ShowRecord.asp?LinkFrom=OAI&ID=12011000249
Dementia
Fischer, C E; Schweizer, T A; Joy, J
Determining the impact of dementia on antidepressant treatment response in older adults.
The Journal of Neuropsychiatry and Clinical Neurosciences, 2011, vol. 23(3)
p 358-361
Depression
Ciro, CA; Ottenbacher, KJ; Graham, JE
Patterns and correlates of depression in hospitalized older adults.
Archives of Gerontology and Geriatrics, January 2012, Vol. 54(1) 202-205
Lapid, Maria I; Piderman, Katherine M
Improvement of quality of life in hospitalized depressed elderly.
International Psychogeriatrics, April 2011, Vol. 23(3) p 485-495
Han, L; McCusker, J; Cole, M
Antidepressant use and cognitive functioning in older medical patients with major or minor depression: A prospective cohort study with database linkage.
Journal of Clinical Psychopharmacology, August 2011, vol. 31(4) 429-435
Dignity
Wood, Julia
Review of Dignity in care for older people.
Nursing Ethics, May 2011, Vol.18(3) p 459
Webster, C; Bryan, K
Older people's views of dignity and how it can be promoted in a hospital environment.
Journal of Clinical Nursing, June 2009, vol. 18(12) p 1784-1792
Webster, C; Bryan, K
Older people's views of dignity and how it can be promoted in a hospital environment.
Journal of Clinical Nursing, June 2009, vol. 18(12) p 1784-1792
