Prestigious Dhole-Eddlestone Memorial Prize awarded to ‘Probable delirium is a presenting symptom of COVID-19 in frail, older adults: a cohort study of 322 hospitalised and 535 community-based older adults’

13 January 2021

The prestigious Dhole-Eddlestone Memorial Prize has been awarded to the Age and Ageing paper ‘Probable delirium is a presenting symptom of COVID-19 in frail, older adults: a cohort study of 322 hospitalised and 535 community-based older adults’. The prize is given annually to the most deserving medical research relating to the needs of older people, published over the last year in the scientific journal of the British Geriatrics Society, Age and Ageing.

The paper, published on 28 September 2020, was the first study confirming that delirium is a symptom of COVID-19 in older adults. The study provided evidence that clinicians should suspect COVID-19 in frail adults presenting with delirium, even when they do not have classical COVID symptoms such as cough, fever and breathlessness. This finding has proved invaluable as the pandemic has progressed.

Delirium is a frequent complication of illness, injury or drug treatment in older adults characterized by the sudden onset or worsening of confusion, often associated with drowsiness or agitation. It is common among older hospitalized patients, especially people living with prior dementia, although exactly why it arises is not well-understood. Previous studies have shown that delirium is related to a number of adverse outcomes for older patients including a longer mean length of hospital stay, the need for institutional care, and increased mortality rates.

For the study, the researchers analysed data from two groups of older people aged 65 or over from March through May. The first group included 322 patients admitted to the hospital with COVID-19 who had tested positive for the virus, while the second comprised 535 users of the COVID Symptom Study app who reported having had a positive test result.

The authors of the paper found that older adults admitted to hospital who were classified as frail were more likely to have had delirium as one of their symptoms than people of the same age who were not classified as frail. A third of app users experiencing delirium did not report suffering the ‘typical’ COVID-19 symptoms of cough and fever, while delirium was the only symptom for around one in five (18.9%) of hospitalised patients.

Few of the early studies of COVID-19 included delirium or ‘new confusion’, therefore this ground-breaking paper attracted global attention. Highly relevant to healthcare professionals and the public alike, to date there have been 142 news stories featuring the study’s findings, 1 million impressions on Twitter and citations in a variety of prestigious scientific journals including The Lancet.  

Dr Claire J Steves, Consultant Geriatrician at Guys and St Thomas’s NHS Foundation Trust and Clinical Senior Lecturer at King’s College London, led the study. She commented:

We are hugely honoured to receive this award and our thanks go to all the frontline junior doctors, patients and app participants from all over the UK whose logging of symptoms and signs helped us show how new confusion, even on its own, can be a sign of COVID-19 in frail older people. Thanks to Age and Ageing, this work changed guidance on testing which we hope means older people can be treated earlier with less chance for the disease to spread in this critical group and their carers.”

Professor Rowan Harwood, Editor-in-Chief of Age and Ageing, commented:

The judging panel were particularly impressed by this research which was topical, collaborative, rigorous, answering an urgent question for clinicians and which has already had impact on policy and practice. Undertaking research has been difficult during the pandemic, and those achieving results deserve our admiration and thanks. It is research which will eventually see us conquer this pandemic.”

The paper will be presented, and the Dhole-Eddlestone Memorial Prize awarded, at the BGS Spring Meeting, which is being held online 28-30 April 2021.

Read the full paper ‘Probable delirium is a presenting symptom of COVID-19 in frail, older adults: a cohort study of 322 hospitalised and 535 community-based older adults’ here:

The Dhole-Eddlestone Memorial Prize is funded by a legacy from Dr Manindra Kumar Dhole, a BGS member who died in 1977. The prize is so named to commemorate the anniversary of his marriage with Dr Eddlestone. One cash prize of £1,000 is made each year and announced on 14 January, the anniversary of the date of their marriage. Applications are not accepted. The prize goes to ‘the most deserving published work of medical research appertaining to the needs of aged people’, in practice, the paper published in Age and Ageing each calendar year which most impressed the judging panel.