Sharon K. Inouye, MD, MPH: Why is Delirium During Hospitalization Not Taken Seriously?

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This ACP Conference interview featured a discussion with Inouye about gaps in knowledge regarding patients experiencing delirium during hospitalization.

In another segment of her interview at the 2024 American College of Physicians (ACP) Internal Medicine Meeting in Boston, Sharon K. Inouye, MD, MPH, MCAP, delved further into the major talking points of her presentation ‘Delirium During Hospitalization.’

Inouye is known for her work as professor of medicine at Harvard Medical School, as well as her work as Milton and Shirley F. Levy Family chair and director of the Aging Brain Center of the Hinda and Arthur Marcus Institute for Aging Research. Additionally, Inouye serves as editor-in-chief of JAMA Internal Medicine.

In her previous interview segment, Inouye had detailed some of the major takeaways from her discussion, highlighting changes over time that have occurred in teaching medical students and clinicians about the serious problem of delirium faced by many older adults who have been hospitalized. Here, she was asked about what is keeping assessments of delirium from being more widely implemented.

“I think the reason people say they can't do it is they claim they don't have time,” Inouye said. “But now we've created this ultra-brief assessment method, widely available and free of charge. We feel like we're eliminating that excuse, but people don't know about it. Spreading the word, I think, is really, really important.”

Inouye expressed that she hoped ACP could circulate the assessment widely so that, at least, the message about the use of the assessment is known more widely to internists.

“The other part of it is that, I think you're right, there isn’t an imperative to recognize delirium,” Inouye explained. “Because people, first of all, don't realize it's preventable. People often think, ‘oh, there's nothing to do once an older person becomes confused or anybody becomes confused.’ But there is so much to be done in terms of both optimizing care…nutrition, hydration, making sure that the person is getting mobilized and ready to go home as soon as possible.”

Inouye added that laboratories must also not be in disarray and that medical conditions are under control. She noted that delirium is often a barometer for other things going wrong, which Inouye believes many clinicians do not accept or fully understand.

“There's still some of this thinking that I told you I experienced 35 years ago, thinking ‘well, delirium is just inevitable and it's just going to happen to older adults when they're sick, so there's nothing that can be done.’ We really want to counter that thinking. And I think more and more hospitals are realizing this and they're starting to realize that these patients who get confused in the hospitals are costing them a lot of money.”

For additional information on the presentation topic, view the full interview segment posted above. Other conference coverage is available as well.

The quotes contained in this interview were edited for the purposes of clarity. Inouye had no relevant disclosures.