{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:57:16Z","timestamp":1792112236766,"version":"4.4.0"},"reference-count":59,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Medical Research Council Unit for Lifelong Health and Ageing at University College London","award":["MC_UU_00019\/1"],"award-info":[{"award-number":["MC_UU_00019\/1"]}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["WT107467"],"award-info":[{"award-number":["WT107467"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000377","name":"Dunhill Medical Trust","doi-asserted-by":"publisher","award":["RPGF1902\\147"],"award-info":[{"award-number":["RPGF1902\\147"]}],"id":[{"id":"10.13039\/501100000377","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Delirium presents formidable challenges: it affects one in four of older hospitalised adults, greatly elevates the risk of multiple short- and long-term complications including dementia and causes significant distress. Delirium care remains generally poor. Yet, there are clear grounds for optimism; the last decade has seen impactful policy advances and a tripling of research output. Here, we highlight three linked areas which have strong potential to transform delirium practice and knowledge in the near term.<\/jats:p><jats:p>Delirium-related distress is strikingly underrepresented in practice guidance and research. Proactive recognition combined with effective clinical responses based on good communication provides a critical and largely untapped opportunity to improve care.<\/jats:p><jats:p>Delirium epidemiology research is well positioned to produce novel insights through advanced prospective designs in populations such as emergency medical patients with detailed pre-, intra- and post-delirium assessments allied with fluid, imaging and other biomarkers.<\/jats:p><jats:p>Research-grade assessment of delirium currently involves a chaotic array of tools, methods and diagnostic algorithms. Areas for development: expand and analytically distinguish the range of features assessed (including distress), optimise feature assessment including use of validated neuropsychological tests where possible, produce standardised algorithms which articulate explicit pathways from features to diagnosis, and create new fine-grained approaches to the measurement of severity.<\/jats:p><jats:p>Delirium practice and knowledge show accelerating growth. This is encouraging but much of the necessary progress is still to come. Innovation in these three highlighted areas, as well as many others, will open up exciting possibilities in enhancing the care of patients with this common and often devastating condition.<\/jats:p>","DOI":"10.1093\/ageing\/afac271","type":"journal-article","created":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T22:33:38Z","timestamp":1669415618000},"source":"Crossref","is-referenced-by-count":22,"title":["Three key areas in progressing delirium practice and knowledge: recognition and relief of distress, new directions in delirium epidemiology and developing better research assessments"],"prefix":"10.1093","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3159-9370","authenticated-orcid":false,"given":"Alasdair M J","family":"MacLullich","sequence":"first","affiliation":[{"name":"Edinburgh Delirium Research Group, Ageing and Health, Usher Institute, University of Edinburgh , Edinburgh , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1674-2124","authenticated-orcid":false,"given":"Annmarie","family":"Hosie","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery, The University of Notre Dame Australia , Darlinghurst, NSW , Australia"},{"name":"The Cunningham Centre for Palliative Care, St Vincent\u2019s Health Network Sydney , Darlinghurst, NSW , Australia"},{"name":"IMPACCT \u2013 Improving Palliative, Aged and Chronic Care through Research and Translation, University of Technology Sydney , Ultimo, NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3820-3917","authenticated-orcid":false,"given":"Zo\u00eb","family":"Tieges","sequence":"additional","affiliation":[{"name":"Edinburgh Delirium Research Group, Ageing and Health, Usher Institute, University of Edinburgh , Edinburgh , UK"},{"name":"SMART Technology Centre, School of Computing, Engineering and Built Environment, Glasgow Caledonian University , Glasgow , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel H J","family":"Davis","sequence":"additional","affiliation":[{"name":"MRC Unit for Lifelong Health and Ageing, University College London , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,11,28]]},"reference":[{"key":"2023031605453828700_","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1093\/ageing\/afaa040","article-title":"The consistent burden in published estimates of delirium occurrence in medical inpatients over four decades: a systematic review and meta-analysis study","volume":"49","author":"Gibb","year":"2020","journal-title":"Age 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