Abstract
Introduction
Delirium is a common acute neuropsychiatric disorder, affecting approximately 23% of older adults admitted to hospitals in the UK. It is often triggered by acute illness and is associated with a high in-hospital mortality rate of around 30%. While delirium typically resolves, many patients experience prolonged cognitive and functional decline. Despite its prevalence, structured post-hospital follow-up services remain limited, leading to increased emergency department (ED) reattendance, hospital readmissions, and delayed recognition of cognitive impairment.
Method
To address this gap, we established a geriatrician-led outpatient delirium follow-up service at East Surrey Hospital. This service targets patients aged 65 and over, discharged within the last eight weeks with a new delirium diagnosis and no prior formal dementia diagnosis. Our consultant-led multidisciplinary clinic conducts comprehensive geriatric and cognitive assessments to improve patient outcomes, enable early referral to memory services, support advance care planning, and assist families and carers. Cognitive testing includes the Addenbrooke’s Cognitive Examination III (ACE-III) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE).
Results
Over four months, 13 patients with new-onset delirium were assessed. Of these, eight (62%) showed probable cognitive impairment, while five (38%) had no significant impairment. Those with suspected impairment were referred to Specialist Memory Clinics for further evaluation.
Conclusion
Our delirium follow-up service enables early detection of cognitive impairment, facilitating timely dementia diagnoses and better access to community support. Given that few centres currently offer this service, expanding this model across the healthcare system could improve outcomes for patients recovering from delirium.