[Sportschosun Reporter Jang Jong-ho] A study has found that an "integrated delirium management program" that adjusts high-risk medications and combines measures such as cognitive boards and morning sunlight exposure is effective in reducing delirium severity in older hospitalized patients.
Delirium is an acute brain dysfunction marked by impaired awareness of time and place, abnormal behavior, and hallucinations. It is common, affecting about one in four hospitalized older adults, and it raises the risk of falls while reducing physical function, which can negatively affect recovery and prognosis.
Current major guidelines for delirium recommend medication review and nonpharmacological interventions that help patients stay oriented to time and place and restore normal sleep-wake cycles as key preventive strategies. However, older patients often take multiple drugs for various conditions, making it difficult to adjust high-risk medications. In addition, it is not easy to systematically combine different nonpharmacological interventions within limited staff and time, leaving a shortage of practical integrated models.
Against this backdrop, a research team led by Professor Park Hye-yeon of the Department of Psychiatry and Professor Kim, Sun-Wook of the Department of Internal Medicine at Seoul National University Bundang Hospital said it developed a program that integrates the various intervention elements needed for delirium management into a single system and confirmed its effectiveness after applying it in actual wards.
The team designed the integrated delirium management program so that delirium would not worsen even if it occurred in hospitalized patients, and so that it could be implemented within limited staff and time.
When a patient is admitted, psychiatric staff first review and adjust high-risk delirium medications, including benzodiazepines and anticholinergic drugs. The program also combines delirium prevention education videos, cognitive boards placed near the bedside to help maintain orientation to time, place, and person, and phototherapy that exposes patients to bright morning light each day to help restore the sleep-wake cycle.
The care system, which had been centered on medical staff, was expanded to include caregivers. This allowed family members, who know the patient’s usual condition best, to continuously share information at the bedside and help maintain orientation.
From March 2023 to April 2025, the team conducted a prospective observational study involving 203 patients hospitalized in internal medicine wards, with an average age in their 70s. The program was applied to 64 patients in the intervention group, while the remaining 139 patients in the observation group received standard care. The researchers then compared changes in delirium severity on days 1, 3, and 7 of hospitalization.
The analysis showed that the intervention group had significantly lower delirium severity on day 7 than the observation group. Among the intervention components, medication adjustment showed the fastest effect, beginning on day 3 and lasting through day 7. The study also demonstrated a "cumulative effect," with greater improvement in delirium on day 7 as more intervention components were applied, underscoring the importance of integrated care.
This study is meaningful because it combined delirium interventions that had previously been carried out separately into a single integrated program and confirmed its effectiveness in real inpatient wards. It proposed a "stepwise approach" in which high-risk medications are adjusted quickly at the start of hospitalization, while nonpharmacological interventions such as cognitive boards and educational videos are concentrated on high-risk patients, improving the program’s practicality in ward settings. It is also important that the model addressed the shortage of medical staff by using cognitive boards and involving caregivers.
Professor Park Hye-yeon said, "Because of polypharmacy in older patients and limited medical resources, it has been difficult to consistently apply the various interventions needed for delirium management." She added, "Through this study, we were able to present an integrated management model that can be sufficiently implemented in real inpatient wards by combining delirium-risk medication adjustment with the participation of patients and caregivers."
She added, "Going forward, we plan to follow patients not only during hospitalization but also after discharge, and develop a personalized delirium prevention and management system based on each patient’s risk level."
Meanwhile, the study was supported by the Ministry of Health and Welfare (MOHW) patient-centered medical technology optimization research project, and the findings were published in the April 2026 issue of the international geriatric journal Age and Ageing.
Jang Jong-ho, bellho@sportschosun.com
This article has been translated by GripLabs Mingo AI.
