Analgesic and psychoactive medications and the risk of falls in relation to delirium in single-bed rooms compared to multiple-bed rooms in geriatric inpatients

BACKGROUND: Previously, we demonstrated a substantial reduction of delirium incidence among geriatric patients after relocating from old hospital buildings with multiple-bed rooms to a new hospital with single-bed rooms.

AIMS: To investigate whether (1) the reduced incidence of delirium in single-bed rooms was associated with a simultaneous change in medication use, (2) the relocation had affected the incidence of falls, (3) the use of analgesics and psychoactive medications was associated with the risk of delirium and falls.

METHODS: We included 461 admissions to the old wards and 553 admissions to the new wards. Delirium was assessed by the Confusion Assessment Method. Data on drug use and falls during hospitalization were extracted from medical records.

RESULTS: There was no difference in drug use between the wards. In the new wards, patients who had experienced delirium had a much higher risk of falls than patients without delirium, while in the old wards this contrast was small. The risk of delirium was increased among patients who received antipsychotic drugs and anti-dementia drugs, Patients who received these drugs had an insignificantly increased risk of falls.

CONCLUSION: Medication of analgesics and psychoactive drugs was similar in the old and new wards. In single-bed rooms, but not in multiple-bed rooms there was a much higher risk of falls among inpatients that developed delirium than among other patients. Patients who had used antipsychotics and anti-dementia drugs during hospitalization had increased risk of developing delirium and an insignificantly higher risk of falls.