TOPLINE:

Among hospitalized adults aged 70 years or older, the odds for delirium — whether present on admission or acquired in hospital — were elevated for those from marginalized racial and ethnic groups and for those living in more socioeconomically disadvantaged neighborhoods.

METHODOLOGY:

• In this retrospective analysis, researchers reviewed data of older adults to assess whether patient factors related to social marginalization influenced the risk for delirium.
• They included 260,200 older hospitalized adults (median age, 78.0 years; 55.1% women) who were systematically screened for delirium at an eight-hospital healthcare system in the US between 2018 and 2024.
• Researchers analyzed multiple parameters including sex, age, race, and comorbidities.
• The Area Deprivation Index (ADI) was used to assess the socioeconomic status of neighborhoods, with higher scores for more disadvantaged areas.
• Outcomes focused on identifying patient factors associated with increased odds of delirium occurrence, either present on admission or acquired in hospital. Hospital outcomes included the length of stay, mortality, and discharge disposition.

TAKEAWAY:

• Of screened patients, 25.5% had delirium on admission, and 10.4% later developed hospital-acquired delirium.
• The odds of having delirium on admission were elevated in patients who were Black individuals (adjusted odds ratio [aOR], 1.49; 95% CI, 1.44-1.54) or Hispanic individuals (aOR, 1.31; 95% CI, 1.26-1.36) or had prior dementia (aOR, 6.53; 95% CI, 6.37-6.68).
• The odds of having hospital-acquired delirium were significantly elevated in men, adults who were Black or Hispanic individuals, those with prior dementia, and those living in higher ADI neighborhoods, with aORs ranging from 1.02 to 2.44.
• Delirium on admission or acquired in hospital was associated with longer stays in hospital, in-hospital mortality, and a greater chance of being discharged to specialized facilities. These hospital outcomes were found across all racial/ethnic subgroups.

IN PRACTICE:

“By systematically addressing delirium prevention, early recognition, and management for risk-prone older adults, we can provide meaningful healthcare improvement for even the most vulnerable populations who disparately carry the highest burden,” the researchers wrote.

SOURCE:

This study was led by Alan P. Pan, of Center for Health Data Science and Analytics at Houston Methodist in Houston. It was published online on September 30, 2025, in the Journal of the American Geriatrics Society.

LIMITATIONS:

Delirium was identified using screening tools completed by nurses, without full clinical diagnostic exams. Data on race and ethnicity was retrieved from electronic health records, which may have been recorded inaccurately.

DISCLOSURES:

The authors reported receiving no specific funding for this study and declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.