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Commentary on: Pomeroy ML, Cudjoe TKM, Cuellar AE, et al. Association of social isolation with hospitalization and nursing home entry among community-dwelling older adults. JAMA Int Med. 2023; 183(9): 955–62. https://doi.org/10.1001/jamainternmed.2023.3064
Social isolation is a significant risk factor for nursing home placement for older adults, and public health interventions to improve social connections are urgently needed. Future research should address interventions across the lifespan and for those more vulnerable to isolation and loneliness, testing practical ways to improve social connectiveness.
The quality of our lives is the quality of our relationships. As we approach a challenging time of the year for loneliness and isolation, what do we know about social isolation and healthcare utilisation in older adults? Almost a quarter of community-dwelling older adults experience social isolation.
To synthesise the evidence on and to compare the diagnostic accuracy of the Nu-DESC and CAM in detecting postoperative delirium among hospitalised patients.
Systematic review and diagnostic meta-analysis.
The PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, ProQuest Dissertations and Theses A&I, and PsycINFO databases were systematically searched from their inception to February 10, 2023.
In total, 10 (n = 1950) and seven (n = 830) reports were included for the Nu-DESC and CAM, respectively. For Nu-DESC and CAM, the pooled sensitivities were 0.69 and 0.65, respectively, while the summary specificities were 0.99 for Nu-DESC and 0.92 for CAM. The pooled specificity differed significantly between the two tools (p < 0.001), despite comparable pooled sensitivities. The duration of stay in the intensive care unit significantly moderated the summary specificity of Nu-DESC (B = −0.0003, p = 0.009). Regarding CAM, the percentage of female participants showed a positive correlation with its pooled sensitivity (B = 0.005, p = 0.02). Furthermore, studies where clinical specialists served as assessors demonstrated a higher summary sensitivity than those assessed by nurses (0.87 vs. 0.25, p = 0.01).
The sensitivities of the Nu-DESC and CAM for detecting postoperative delirium did not achieve optimal levels. Therefore, developing more accurate tools to detect postoperative delirium by integrating features from related risk factors or incorporating technology-based algorithms to enhance the screening capability is warranted.
The study has adhered to PRISMA-DTA guideline.
No patient or public contribution.
The study protocol has been registered on PROSPERO (CRD42023398961)
FreshRSS 