Multicomponent Non-Pharmacological Interventions for Delirium Prevention in Hospitalized Older Adults: A Systematic Review

Abstract

Introduction: Delirium is a common and serious complication in hospitalized older adults, associated with increased mortality and functional decline. This review evaluates the effectiveness of multicomponent, non-pharmacological interventions for delirium prevention.

Methods: A search for RCTs was conducted in several databases. We included studies of bundled, multicomponent interventions targeting delirium risk factors (e.g., promoting mobility, sleep, hydration; managing sensory impairment) in hospitalized adults aged 65 or older.

Results: The meta-analysis of 15 RCTs showed that multicomponent interventions significantly reduced the incidence of delirium by approximately 30-40% compared to usual care. The interventions were most effective in medical and surgical ward settings.

Discussion: A proactive, multicomponent approach that addresses key delirium risk factors is a highly effective strategy for primary prevention. This approach, often implemented through programs like the Hospital Elder Life Program (HELP), should be a standard of care.

Conclusion: Multicomponent non-pharmacological interventions are effective in preventing delirium in hospitalized older adults.