Delirium Identification in Older Patients With Alzheimer's and Other Related Dementias In the Emergency Department
Delirium Identification in Older Patients With Alzheimer's and Other Related Dementias In the Emergency Department Using Wrist Accelerometer Biosensors and Machine Learning
Ohio State University
60 participants
Apr 10, 2024
OBSERVATIONAL
Conditions
Summary
Delirium is highly prevalent and very bad for patients with dementia. Delirium is a dangerous medical condition that occurs in 6-38% of older Emergency Department patients and 70% of ICU patients. A person who develops delirium in the ED or hospital has a 12 times higher odds of being newly diagnosed with dementia in the next year compared to a similar patient who does not become delirious. Delirium is especially dangerous for persons living with Alzheimer Disease and Related Dementias (AD/ADRD). Persons living with ADRD have an almost 50% chance of developing delirium in the hospital. Clinicians are bad at recognizing delirium. A recent systematic review led by the Geriatric Emergency Care Applied Research network (NIH funded) found that current delirium screening tools are at most 64% sensitive, meaning that physicians can identify some phenotypes of delirium well, but cannot easily rule out delirium in acutely ill older patients. The investigators propose integrating wrist biosensors into the emergency management of older adults with dementia. The investigators will monitor heart rate variability, movement, and electrodermal activity (electrical activity of at the level of the skin) to determine if an array of biosensors more sensitive to delirium than current verbal screening tools.
Eligibility
Inclusion Criteria2
- adults patients 65+ years old with a known diagnosis of dementia or medical team highly suspects or confirms dementia this visit.
- Emergency Department visit and/or hospitalization anticipated to last \>4 more hours from the time of enrollment.
Exclusion Criteria3
- Intubation/mechanical ventilation
- Patients undergoing a procedure requiring sedation
- Patients who cannot consent due to cognitive impairment and do not have a legally authorized representative or caregiver present.
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Interventions
wear a biosensor watch to passively collect biosensor data over 48 hours. The EmbracePlus will collect heart rate variability, accelerometry, and electrodermal activity.
Locations(1)
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NCT06326424