Chukwuma Okoye MD, PhD , Maria Beatrice Zazzara MD, PhD , Chiara Ceolin MD , Giorgio Fedele MD, PhD , Annapina Palmieri MD , Angela Marie Abbatecola MD, PhD , Alba Malara MD , Caterina Trevisan MD, PhD , Suzanne Timmons MD , Rosa Prato MD , Francesca Fortunato MD , Susanna Del Signore MD , Giuseppe Bellelli MD, PhD , Raffaele Antonelli Incalzi MD, PhD , Graziano Onder MD, PhD , Alessandra Coin MD, PhD , GeroCovid Vax Working Group
{"title":"长期护理机构 (LTCF) 中已接种 SARS-CoV-2 疫苗的居民的谵妄发生率和预测因素：来自 GeroCovid Vax 研究的启示。","authors":"Chukwuma Okoye MD, PhD , Maria Beatrice Zazzara MD, PhD , Chiara Ceolin MD , Giorgio Fedele MD, PhD , Annapina Palmieri MD , Angela Marie Abbatecola MD, PhD , Alba Malara MD , Caterina Trevisan MD, PhD , Suzanne Timmons MD , Rosa Prato MD , Francesca Fortunato MD , Susanna Del Signore MD , Giuseppe Bellelli MD, PhD , Raffaele Antonelli Incalzi MD, PhD , Graziano Onder MD, PhD , Alessandra Coin MD, PhD , GeroCovid Vax Working Group","doi":"10.1016/j.jamda.2024.105251","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>SARS-CoV-2 vaccination can bring an important benefit for older people in terms of reduction of mortality and hospitalization; however, reports of rare adverse effects like altered consciousness and delirium among this demographic have raised concerns. This study aimed to assess delirium incidence post-SARS-CoV-2 vaccination and its predictors in older residents across 60 Italian long-term care facilities (LTCFs).</p></div><div><h3>Design</h3><p>This is a prospective cohort study considering data from GeroCovid Vax, a multicenter cohort study jointly performed by the Italian Society of Gerontology and Geriatrics (SIGG) (Florence, Italy) and the Italian National Institute of Health (Istituto Superiore di Sanità—ISS, Rome, Italy), and sponsored by the Italian Medicines Agency (Agenzia Italiana del Farmaco—AIFA).</p></div><div><h3>Setting and Participants</h3><p>GeroCovid Vax enrolled LTCFs residents aged ≥60 who received at least 1 anti–SARS-CoV-2 vaccine dose.</p></div><div><h3>Methods</h3><p>Baseline data covered sociodemographic details, chronic diseases, medications, nutritional status, cognitive and functional assessments, mobility, and frailty. Delirium was assessed post-first, second, and booster vaccine doses using DSM-5 criteria. Data analysis involved descriptive statistics, multivariate logistic regression, and network analysis.</p></div><div><h3>Results</h3><p>A total of 2521 participants (mean age 83.10 ± 9.21 years, 70.7% female) were analyzed. Delirium incidence post-first, second, and booster doses was 3.5%, 1.6%, and 1.5%, respectively. Age, preexisting cognitive disorders, and frailty were significant predictors of delirium, with odds ratios (ORs) of 1.70 (95% CI, 1.08–2.77), 2.05 (95% CI, 1.40–2.97), and 1.77 (95% CI, 1.25–2.52), respectively. Prior use of antipsychotics (OR, 1.75; 95% CI, 1.22–2.51) and antidepressants (OR, 1.77; 95% CI, 1.25–2.52) correlated significantly with delirium. Network analysis indicated a strong association between anorexia and delirium.</p></div><div><h3>Conclusion and Implications</h3><p>Post-vaccination delirium is infrequent and decreases with subsequent doses. Timely assessments for frailty and cognitive impairment could aid in stratifying delirium risk among LTCF residents, facilitating enhanced prevention measures and close monitoring for delirium indicators.</p></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"25 11","pages":"Article 105251"},"PeriodicalIF":4.2000,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S152586102400673X/pdfft?md5=4e4ac7fe66a04a4739589e49323a2627&pid=1-s2.0-S152586102400673X-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Delirium Incidence and Predictors in SARS-CoV-2 Vaccinated Residents in Long-Term Care Facilities (LTCF): Insights from the GeroCovid Vax Study\",\"authors\":\"Chukwuma Okoye MD, PhD , Maria Beatrice Zazzara MD, PhD , Chiara Ceolin MD , Giorgio Fedele MD, PhD , Annapina Palmieri MD , Angela Marie Abbatecola MD, PhD , Alba Malara MD , Caterina Trevisan MD, PhD , Suzanne Timmons MD , Rosa Prato MD , Francesca Fortunato MD , Susanna Del Signore MD , Giuseppe Bellelli MD, PhD , Raffaele Antonelli Incalzi MD, PhD , Graziano Onder MD, PhD , Alessandra Coin MD, PhD , GeroCovid Vax Working Group\",\"doi\":\"10.1016/j.jamda.2024.105251\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>SARS-CoV-2 vaccination can bring an important benefit for older people in terms of reduction of mortality and hospitalization; however, reports of rare adverse effects like altered consciousness and delirium among this demographic have raised concerns. This study aimed to assess delirium incidence post-SARS-CoV-2 vaccination and its predictors in older residents across 60 Italian long-term care facilities (LTCFs).</p></div><div><h3>Design</h3><p>This is a prospective cohort study considering data from GeroCovid Vax, a multicenter cohort study jointly performed by the Italian Society of Gerontology and Geriatrics (SIGG) (Florence, Italy) and the Italian National Institute of Health (Istituto Superiore di Sanità—ISS, Rome, Italy), and sponsored by the Italian Medicines Agency (Agenzia Italiana del Farmaco—AIFA).</p></div><div><h3>Setting and Participants</h3><p>GeroCovid Vax enrolled LTCFs residents aged ≥60 who received at least 1 anti–SARS-CoV-2 vaccine dose.</p></div><div><h3>Methods</h3><p>Baseline data covered sociodemographic details, chronic diseases, medications, nutritional status, cognitive and functional assessments, mobility, and frailty. Delirium was assessed post-first, second, and booster vaccine doses using DSM-5 criteria. Data analysis involved descriptive statistics, multivariate logistic regression, and network analysis.</p></div><div><h3>Results</h3><p>A total of 2521 participants (mean age 83.10 ± 9.21 years, 70.7% female) were analyzed. Delirium incidence post-first, second, and booster doses was 3.5%, 1.6%, and 1.5%, respectively. Age, preexisting cognitive disorders, and frailty were significant predictors of delirium, with odds ratios (ORs) of 1.70 (95% CI, 1.08–2.77), 2.05 (95% CI, 1.40–2.97), and 1.77 (95% CI, 1.25–2.52), respectively. Prior use of antipsychotics (OR, 1.75; 95% CI, 1.22–2.51) and antidepressants (OR, 1.77; 95% CI, 1.25–2.52) correlated significantly with delirium. Network analysis indicated a strong association between anorexia and delirium.</p></div><div><h3>Conclusion and Implications</h3><p>Post-vaccination delirium is infrequent and decreases with subsequent doses. 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Delirium Incidence and Predictors in SARS-CoV-2 Vaccinated Residents in Long-Term Care Facilities (LTCF): Insights from the GeroCovid Vax Study
Objective
SARS-CoV-2 vaccination can bring an important benefit for older people in terms of reduction of mortality and hospitalization; however, reports of rare adverse effects like altered consciousness and delirium among this demographic have raised concerns. This study aimed to assess delirium incidence post-SARS-CoV-2 vaccination and its predictors in older residents across 60 Italian long-term care facilities (LTCFs).
Design
This is a prospective cohort study considering data from GeroCovid Vax, a multicenter cohort study jointly performed by the Italian Society of Gerontology and Geriatrics (SIGG) (Florence, Italy) and the Italian National Institute of Health (Istituto Superiore di Sanità—ISS, Rome, Italy), and sponsored by the Italian Medicines Agency (Agenzia Italiana del Farmaco—AIFA).
Setting and Participants
GeroCovid Vax enrolled LTCFs residents aged ≥60 who received at least 1 anti–SARS-CoV-2 vaccine dose.
Methods
Baseline data covered sociodemographic details, chronic diseases, medications, nutritional status, cognitive and functional assessments, mobility, and frailty. Delirium was assessed post-first, second, and booster vaccine doses using DSM-5 criteria. Data analysis involved descriptive statistics, multivariate logistic regression, and network analysis.
Results
A total of 2521 participants (mean age 83.10 ± 9.21 years, 70.7% female) were analyzed. Delirium incidence post-first, second, and booster doses was 3.5%, 1.6%, and 1.5%, respectively. Age, preexisting cognitive disorders, and frailty were significant predictors of delirium, with odds ratios (ORs) of 1.70 (95% CI, 1.08–2.77), 2.05 (95% CI, 1.40–2.97), and 1.77 (95% CI, 1.25–2.52), respectively. Prior use of antipsychotics (OR, 1.75; 95% CI, 1.22–2.51) and antidepressants (OR, 1.77; 95% CI, 1.25–2.52) correlated significantly with delirium. Network analysis indicated a strong association between anorexia and delirium.
Conclusion and Implications
Post-vaccination delirium is infrequent and decreases with subsequent doses. Timely assessments for frailty and cognitive impairment could aid in stratifying delirium risk among LTCF residents, facilitating enhanced prevention measures and close monitoring for delirium indicators.
期刊介绍：
JAMDA, the official journal of AMDA - The Society for Post-Acute and Long-Term Care Medicine, is a leading peer-reviewed publication that offers practical information and research geared towards healthcare professionals in the post-acute and long-term care fields. It is also a valuable resource for policy-makers, organizational leaders, educators, and advocates.
The journal provides essential information for various healthcare professionals such as medical directors, attending physicians, nurses, consultant pharmacists, geriatric psychiatrists, nurse practitioners, physician assistants, physical and occupational therapists, social workers, and others involved in providing, overseeing, and promoting quality
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