{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T23:45:01Z","timestamp":1789429501210,"version":"build-2803163510"},"reference-count":130,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Delirium is a serious neuropsychiatric condition common among older adults, associated with prolonged hospital stays, increased morbidity and mortality. Although guidelines emphasise prevention, identifying most effective measures is crucial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the efficacy of non-pharmacological and pharmacological interventions in preventing delirium in older adults (\u226565\u00a0years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review and meta-analysis of randomised controlled trials across settings, excluding ICU-only studies. MEDLINE, Cochrane, Web of Science and PsycINFO were searched through October 2024. Comparators included standard care, placebo, or other drugs. Random-effects models estimated pooled risk ratios. Risk of bias was assessed using RoB 2.0. Subgroup analyses were performed by setting and drug type. PROSPERO: CRD42024500387.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eighty-seven trials (19,289 randomised patients) were included. Non-pharmacological multicomponent interventions (k\u2009=\u200917) significantly reduced delirium occurrence (risk ratio [RR]\u2009=\u20090.56, 95% CI 0.45\u20130.72; I2\u00a0=\u200963%) versus usual care, although certainty of evidence was very low. Effects were significant in non-cardiovascular surgical and medical patients. Single-component non-pharmacological interventions (k\u2009=\u20099) showed mixed or inconclusive findings. Among pharmacological trials (k\u2009=\u200953), dexmedetomidine reduced delirium risk (RR\u2009=\u20090.49; 95% CI 0.43\u20130.57; low-certainty) in non-cardiovascular surgical patients. Corticosteroids and intranasal insulin showed significant effects (high-certainty), based on a small number of trials. Mixed strategies, such as haemodynamic or cerebral oxygen-guided approaches, suggested potential benefit but were heterogeneous.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Non-pharmacological multicomponent interventions reduce delirium occurrence and should be prioritised. Dexmedetomidine showed benefit in non-cardiac surgical populations, while evidence for other drugs remains inconclusive. Overall, certainty was low to very low, highlighting the need for further high-quality randomised trials to ensure generalisability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ageing\/afag068","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T16:49:19Z","timestamp":1774889359000},"source":"Crossref","is-referenced-by-count":5,"title":["Effectiveness of non-pharmacological and pharmacological interventions in preventing delirium in older adults: a systematic review and meta-analysis of randomised controlled trials"],"prefix":"10.1093","volume":"55","author":[{"given":"Alba","family":"S\u00e1nchez","sequence":"first","affiliation":[{"name":"Department of Social and Preventive Medicine, University of Potsdam , Potsdam, Brandenburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pallavi","family":"Sawant-Uttekar","sequence":"additional","affiliation":[{"name":"Marien Hospital Stuttgart, Klinik f\u00fcr Geriatrie , Stuttgart, Baden-W\u00fcrttemberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darlene","family":"Heinen","sequence":"additional","affiliation":[{"name":"Department of Social and Preventive Medicine, University of Potsdam , Potsdam, Brandenburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afifah N","family":"Pribadi","sequence":"additional","affiliation":[{"name":"Department of Social and Preventive Medicine, University of Potsdam , Potsdam, Brandenburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Old Age Psychiatry and Psychotherapy, Klinikum Stuttgart , Stuttgart, Baden-W\u00fcrttemberg ,","place":["Germany"]},{"name":"Department of Neurology and Neurophysiology, Medical Center, University of Freiburg , Freiburg, Baden-W\u00fcrttemberg ,","place":["Germany"]},{"name":"Department of Anaesthesiology, Klinikum Stuttgart , Stuttgart, Baden-W\u00fcrttemberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"von Arnim","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, University Medical Center G\u00f6ttingen , Gottingen, Lower Saxony ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"K\u00fchnle","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, University Medical Center G\u00f6ttingen , Gottingen, Lower Saxony ,","place":["Germany"]},{"name":"Department of Geriatric Psychiatry and Psychotherapy, Klinikum Stuttgart , Stuttgart, Baden-W\u00fcrttemberg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK) , G\u00f6ttingen, Lower Saxony ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7623-3423","authenticated-orcid":false,"given":"Stefan Henner","family":"Kreisel","sequence":"additional","affiliation":[{"name":"Division of Geriatric Psychiatry, Department of Psychiatry and Psychotherapy Bethel, Evangelisches Krankenhaus Bielefeld , Bielefeld, North Rhine-Westphalia ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Hewer","sequence":"additional","affiliation":[{"name":"Clinic for Geriatric Psychiatry, Klinikum Christophsbad , G\u00f6ppingen, Baden-W\u00fcrttemberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn","family":"Fath","sequence":"additional","affiliation":[{"name":"Department of Geriatric Psychiatry and Psychotherapy, Klinikum Stuttgart , Stuttgart, Baden-W\u00fcrttemberg ,","place":["Germany"]},{"name":"Clinic for Geriatric Psychiatry, Klinikum Christophsbad , G\u00f6ppingen, Baden-W\u00fcrttemberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3629-252X","authenticated-orcid":false,"given":"Monika","family":"Sadlonova","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, University Medical Center G\u00f6ttingen , Gottingen, Lower Saxony ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK) , G\u00f6ttingen, Lower Saxony ,","place":["Germany"]},{"name":"Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Goettingen , Goettingen, Lower Saxony ,","place":["Germany"]},{"name":"Department of Cardiac, Thoracic and Vascular Surgery, University Medical Center Goettingen , Lower Saxony ,","place":["Germany"]},{"name":"Department of Psychiatry, Massachusetts General Hospital , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0106-966X","authenticated-orcid":false,"given":"Michael","family":"Rapp","sequence":"additional","affiliation":[{"name":"Department of Social and Preventive Medicine, University of Potsdam , Potsdam, Brandenburg ,","place":["Germany"]},{"name":"German Center for Mental Health (DZPG) , Potsdam, Brandenburg, \u00a0","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friederike","family":"Deeken","sequence":"additional","affiliation":[{"name":"Department of Social and Preventive Medicine, University of Potsdam , Potsdam, Brandenburg 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