Donepezil in Preventing Delirium in Hospitalized Elderly

NCT ID: NCT00182884

Last Updated: 2008-03-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-07-31

Study Completion Date

2007-04-30

Brief Summary

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The purpose of this study is to explore the efficacy of a perioperative daily dose of Donepezil (a cholinergic enhancer) in reducing the incidence and severity of delirium.

Detailed Description

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Delirium is confusion or a sudden change in alertness which may happen after hip repair surgery. Up to 65% of elderly undergoing surgical repair of hip fracture experience post-operative delirium. These individuals often stay in the hospital longer, have more complications, and are more likely to die. Early studies suggest that delirium could be prevented by correcting the central cholinergic deficit that is associated with delirium. Donepezil is currently being used to treat memory loss in patients with Alzheimer's disease.

This study will recruit 30 adults aged 65 or older who are undergoing hip fracture surgery. Participants will be randomized to receive either Donepezil or a matching placebo within 24 hours prior to surgery and for 4 days after the surgery.

All material to be collected will be from interviews, questionnaires, and medical chart review at baseline and daily for the entire hospital stay. The Confusion Assessment Method (CAM) and Memorial Delirium Assessment Scale (MDAS) will be used to evaluate the effect of Donepezil on delirium incidence and severity. Other assessments include cognitive deficit, length of hospitalization, discharge site, adverse effects, and psychotropic medications.

Conditions

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Postoperative Complications Delirium

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Interventions

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Donepezil

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Community-dwelling individuals aged 65 or older
* Admitted to Methodist Hospital for surgical repair of hip fracture
* No evidence of delirium at admission to hospital
* MMSE total score below 24 points after adjustment for education and age
* Consent to participate in the study

Exclusion Criteria

* Severely demented as defined by MMSE score below 10
* Metastatic cancer or other comorbid illnesses likely to reduce life expectancy to under 6 months
* Multiple trauma or pathological fractures
* Aphasic, legally blind, or deaf
* Use of Donepezil or other cholinesterase inhibitors within one month prior to surgery
* Allergy to Donepezil
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Indiana University Health

OTHER

Sponsor Role lead

Principal Investigators

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Malaz Boustani, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

Regenstrief Institute, Indiana University Center for Aging Research

Locations

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Methodist Hospital, Clarian Health Partners

Indianapolis, Indiana, United States

Site Status

Countries

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United States

References

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Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med. 1990 Dec 15;113(12):941-8. doi: 10.7326/0003-4819-113-12-941.

Reference Type BACKGROUND
PMID: 2240918 (View on PubMed)

Cooper C, Campion G, Melton LJ 3rd. Hip fractures in the elderly: a world-wide projection. Osteoporos Int. 1992 Nov;2(6):285-9. doi: 10.1007/BF01623184.

Reference Type BACKGROUND
PMID: 1421796 (View on PubMed)

Cummings SR, Rubin SM, Black D. The future of hip fractures in the United States. Numbers, costs, and potential effects of postmenopausal estrogen. Clin Orthop Relat Res. 1990 Mar;(252):163-6.

Reference Type BACKGROUND
PMID: 2302881 (View on PubMed)

Barrett-Connor E. The economic and human costs of osteoporotic fracture. Am J Med. 1995 Feb 27;98(2A):3S-8S. doi: 10.1016/s0002-9343(05)80037-3. No abstract available.

Reference Type BACKGROUND
PMID: 7709931 (View on PubMed)

Galanakis P, Bickel H, Gradinger R, Von Gumppenberg S, Forstl H. Acute confusional state in the elderly following hip surgery: incidence, risk factors and complications. Int J Geriatr Psychiatry. 2001 Apr;16(4):349-55. doi: 10.1002/gps.327.

Reference Type BACKGROUND
PMID: 11333420 (View on PubMed)

Gustafson Y, Berggren D, Brannstrom B, Bucht G, Norberg A, Hansson LI, Winblad B. Acute confusional states in elderly patients treated for femoral neck fracture. J Am Geriatr Soc. 1988 Jun;36(6):525-30. doi: 10.1111/j.1532-5415.1988.tb04023.x.

Reference Type BACKGROUND
PMID: 2897391 (View on PubMed)

Other Identifiers

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VFR-161

Identifier Type: -

Identifier Source: secondary_id

IA0079

Identifier Type: -

Identifier Source: org_study_id

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