Sight and Hearing Investigation Into Effects on Delirium

NCT ID: NCT06176625

Last Updated: 2024-09-27

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

1543 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-01-11

Study Completion Date

2023-12-15

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The goal of this observational study is to learn about sensory loss in hospital patients with delirium. The main questions it aims to answer are:

* Are hearing and vision loss related to increased risk of having delirium?
* Do hearing and vision loss contribute to more severe delirium?
* Do sensory loss and/or delirium affect patient satisfaction with hospital care?

Participants will be asked to:

* answer delirium screening questions,
* undergo hearing \& vision screenings, and
* complete questionnaires about the hospital stay.

The second part of this study is a clinical trial. Researchers will compare different hospital units to see if changing communication affects the number of patients with delirium. The main questions it aims to answer are:

• Does sharing information about communication and/or providing hearing devices change the number of hospital patients with delirium?

Participants in the study will be asked to complete delirium screenings and answer questions about their hearing and communication.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

This is a prospective cohort study entitled Sight \& Hearing Investigation into Effects on Delirium (SHIELD), which aims of to characterize the impact of sensory impairment (i.e., vision and/or hearing loss) on inpatient delirium and experience. The initial phase of this research includes delirium, hearing, and vision screenings, as well as questionnaires regarding satisfaction with care, all of which are observational and do not constitute treatment or intervention. Researchers will conduct electronic medical record reviews to determine whether new patients have been admitted to the units of recruitment on a daily basis and collect relevant demographic and medical information. Eligible patients will be screened to with the 4AT identify delirium and the 3D-CAM-S to characterize delirium severity. After obtaining informed consent, patients will undergo bedside hearing and vision screenings, and complete patient satisfaction questionnaires.

The second phase of present study aims to determine the impact of improving communication on delirium in the hospital setting. Screenings will be used to identify delirium and measure severity and patients will be asked to report subjective hearing difficulty. Subsequent intervention will involve addressing communication barriers posed by hearing loss by providing training to clinical nursing staff, reinforcing strategies for effective communication through the use of posted signs, and providing amplification devices to eligible patients.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Hearing Loss Hearing Loss, Age-Related Hearing Disability Delirium Delirium in Old Age Delirium of Mixed Origin Delirium With Dementia Delirium on Emergence Delirium, Cause Unknown Delirium Superimposed on Dementia Delirium Confusional State Delirium;Non Alcoholic Hearing Loss, Bilateral Hearing Loss, Sensorineural Hearing Loss, Functional Hearing Loss, High-Frequency Hearing

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Initial portion of study is observational in nature.

For the interventional portion, a baseline period of data collection will first be completed on all three hospital units. Intervention will be initially implemented in one unit and added in each subsequent unit in succession following equivalent time periods.
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Delirium & Sensory Loss

The observational portion of the study, during which participants are screened for delirium. Consented individuals also complete bedside hearing and vision screenings, and provide information regarding care on patient satisfaction questionnaires.

Group Type NO_INTERVENTION

No interventions assigned to this group

Baseline Delirium Prevalence

This arm of the interventional portion of the study will be used as baseline comparison data to determine whether implementation of the intervention impacted delirium outcomes. Baseline data collection will be collected for each of the units prior to implementation of the intervention.

Group Type NO_INTERVENTION

No interventions assigned to this group

Communication Signage

For patients who report a little or moderate trouble hearing following the implementation of the intervention, a pink sign will be posted to prompt use of effective communication strategies by nursing staff.

Group Type ACTIVE_COMPARATOR

Communication Signage

Intervention Type BEHAVIORAL

Signage regarding effective communication strategies posted on door to patient's room.

Amplifier

For patients who report a lot of trouble hearing following the implementation of the intervention, a blue sign will be posted to prompt nursing staff to remind patient to make use of amplifier provided as part of the study.

Group Type ACTIVE_COMPARATOR

Communication Signage

Intervention Type BEHAVIORAL

Signage regarding effective communication strategies posted on door to patient's room.

Amplifier Use

Intervention Type BEHAVIORAL

Patient is provided amplification device and signage regarding effective communication strategies with reminder to utilize the amplification device posted on door to patient's room.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Communication Signage

Signage regarding effective communication strategies posted on door to patient's room.

Intervention Type BEHAVIORAL

Amplifier Use

Patient is provided amplification device and signage regarding effective communication strategies with reminder to utilize the amplification device posted on door to patient's room.

Intervention Type BEHAVIORAL

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* inpatient on Johns Hopkins Bayview Medicine A, Medicine B, or Carol Ball unit
* communicates using speech and language
* able to converse in English

Exclusion Criteria

* nonverbal
* unable to communicate using English language
* currently under airborne or droplet isolation precautions
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

National Institute on Aging (NIA)

NIH

Sponsor Role collaborator

Johns Hopkins University

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Nicholas S Reed, Au.D., Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Assistant Professor, Department of Epidemiology

Esther Oh, MD, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Associate Professor, Departments of Medicine and Psychiatry

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Johns Hopkins Bayview Medical Center

Baltimore, Maryland, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Pandhi N, Schumacher JR, Barnett S, Smith MA. Hearing loss and older adults' perceptions of access to care. J Community Health. 2011 Oct;36(5):748-55. doi: 10.1007/s10900-011-9369-3.

Reference Type BACKGROUND
PMID: 21301940 (View on PubMed)

Reed NS, Boss EF, Lin FR, Oh ES, Willink A. Satisfaction With Quality of Health Care Among Medicare Beneficiaries With Functional Hearing Loss. Med Care. 2021 Jan;59(1):22-28. doi: 10.1097/MLR.0000000000001419.

Reference Type BACKGROUND
PMID: 32925460 (View on PubMed)

Mick P, Foley DM, Lin FR. Hearing loss is associated with poorer ratings of patient-physician communication and healthcare quality. J Am Geriatr Soc. 2014 Nov;62(11):2207-9. doi: 10.1111/jgs.13113. No abstract available.

Reference Type BACKGROUND
PMID: 25413192 (View on PubMed)

Genther DJ, Betz J, Pratt S, Martin KR, Harris TB, Satterfield S, Bauer DC, Newman AB, Simonsick EM, Lin FR; Health, Aging and Body Composition Study. Association Between Hearing Impairment and Risk of Hospitalization in Older Adults. J Am Geriatr Soc. 2015 Jun;63(6):1146-52. doi: 10.1111/jgs.13456. Epub 2015 Jun 11.

Reference Type BACKGROUND
PMID: 26096388 (View on PubMed)

Reed NS, Assi L, Horiuchi W, Hoover-Fong JE, Lin FR, Ferrante LE, Inouye SK, Miller Iii ER, Boss EF, Oh ES, Willink A. Medicare Beneficiaries With Self-Reported Functional Hearing Difficulty Have Unmet Health Care Needs. Health Aff (Millwood). 2021 May;40(5):786-794. doi: 10.1377/hlthaff.2020.02371.

Reference Type BACKGROUND
PMID: 33939509 (View on PubMed)

Lin FR, Niparko JK, Ferrucci L. Hearing loss prevalence in the United States. Arch Intern Med. 2011 Nov 14;171(20):1851-2. doi: 10.1001/archinternmed.2011.506. No abstract available.

Reference Type BACKGROUND
PMID: 22083573 (View on PubMed)

Congdon N, O'Colmain B, Klaver CC, Klein R, Munoz B, Friedman DS, Kempen J, Taylor HR, Mitchell P; Eye Diseases Prevalence Research Group. Causes and prevalence of visual impairment among adults in the United States. Arch Ophthalmol. 2004 Apr;122(4):477-85. doi: 10.1001/archopht.122.4.477.

Reference Type BACKGROUND
PMID: 15078664 (View on PubMed)

Swenor BK, Ramulu PY, Willis JR, Friedman D, Lin FR. The prevalence of concurrent hearing and vision impairment in the United States. JAMA Intern Med. 2013 Feb 25;173(4):312-3. doi: 10.1001/jamainternmed.2013.1880. No abstract available.

Reference Type BACKGROUND
PMID: 23338042 (View on PubMed)

Lin FR, Yaffe K, Xia J, Xue QL, Harris TB, Purchase-Helzner E, Satterfield S, Ayonayon HN, Ferrucci L, Simonsick EM; Health ABC Study Group. Hearing loss and cognitive decline in older adults. JAMA Intern Med. 2013 Feb 25;173(4):293-9. doi: 10.1001/jamainternmed.2013.1868.

Reference Type BACKGROUND
PMID: 23337978 (View on PubMed)

Hwang PH, Longstreth WT Jr, Thielke SM, Francis CE, Carone M, Kuller LH, Fitzpatrick AL. Longitudinal Changes in Hearing and Visual Impairments and Risk of Dementia in Older Adults in the United States. JAMA Netw Open. 2022 May 2;5(5):e2210734. doi: 10.1001/jamanetworkopen.2022.10734.

Reference Type BACKGROUND
PMID: 35511175 (View on PubMed)

Fong TG, Tulebaev SR, Inouye SK. Delirium in elderly adults: diagnosis, prevention and treatment. Nat Rev Neurol. 2009 Apr;5(4):210-20. doi: 10.1038/nrneurol.2009.24.

Reference Type BACKGROUND
PMID: 19347026 (View on PubMed)

Witlox J, Eurelings LS, de Jonghe JF, Kalisvaart KJ, Eikelenboom P, van Gool WA. Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: a meta-analysis. JAMA. 2010 Jul 28;304(4):443-51. doi: 10.1001/jama.2010.1013.

Reference Type BACKGROUND
PMID: 20664045 (View on PubMed)

Harithasan D, Mukari SZS, Ishak WS, Shahar S, Yeong WL. The impact of sensory impairment on cognitive performance, quality of life, depression, and loneliness in older adults. Int J Geriatr Psychiatry. 2020 Apr;35(4):358-364. doi: 10.1002/gps.5237. Epub 2019 Dec 5.

Reference Type BACKGROUND
PMID: 31736109 (View on PubMed)

Deal JA, Albert MS, Arnold M, Bangdiwala SI, Chisolm T, Davis S, Eddins A, Glynn NW, Goman AM, Minotti M, Mosley T, Rebok GW, Reed N, Rodgers E, Sanchez V, Sharrett AR, Coresh J, Lin FR. A randomized feasibility pilot trial of hearing treatment for reducing cognitive decline: Results from the Aging and Cognitive Health Evaluation in Elders Pilot Study. Alzheimers Dement (N Y). 2017 Jun 21;3(3):410-415. doi: 10.1016/j.trci.2017.06.003. eCollection 2017 Sep.

Reference Type BACKGROUND
PMID: 29067347 (View on PubMed)

Thompson GP, Sladen DP, Borst BJ, Still OL. Accuracy of a Tablet Audiometer for Measuring Behavioral Hearing Thresholds in a Clinical Population. Otolaryngol Head Neck Surg. 2015 Nov;153(5):838-42. doi: 10.1177/0194599815593737. Epub 2015 Jul 16.

Reference Type BACKGROUND
PMID: 26183518 (View on PubMed)

Varadaraj V, Assi L, Gajwani P, Wahl M, David J, Swenor BK, Ehrlich JR. Evaluation of Tablet-Based Tests of Visual Acuity and Contrast Sensitivity in Older Adults. Ophthalmic Epidemiol. 2021 Aug;28(4):293-300. doi: 10.1080/09286586.2020.1846758. Epub 2020 Nov 13.

Reference Type BACKGROUND
PMID: 33185485 (View on PubMed)

Bellelli G, Morandi A, Davis DH, Mazzola P, Turco R, Gentile S, Ryan T, Cash H, Guerini F, Torpilliesi T, Del Santo F, Trabucchi M, Annoni G, MacLullich AM. Validation of the 4AT, a new instrument for rapid delirium screening: a study in 234 hospitalised older people. Age Ageing. 2014 Jul;43(4):496-502. doi: 10.1093/ageing/afu021. Epub 2014 Mar 2.

Reference Type BACKGROUND
PMID: 24590568 (View on PubMed)

Inouye SK, Kosar CM, Tommet D, Schmitt EM, Puelle MR, Saczynski JS, Marcantonio ER, Jones RN. The CAM-S: development and validation of a new scoring system for delirium severity in 2 cohorts. Ann Intern Med. 2014 Apr 15;160(8):526-533. doi: 10.7326/M13-1927.

Reference Type BACKGROUND
PMID: 24733193 (View on PubMed)

Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, Brayne C, Burns A, Cohen-Mansfield J, Cooper C, Costafreda SG, Dias A, Fox N, Gitlin LN, Howard R, Kales HC, Kivimaki M, Larson EB, Ogunniyi A, Orgeta V, Ritchie K, Rockwood K, Sampson EL, Samus Q, Schneider LS, Selbaek G, Teri L, Mukadam N. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020 Aug 8;396(10248):413-446. doi: 10.1016/S0140-6736(20)30367-6. Epub 2020 Jul 30. No abstract available.

Reference Type BACKGROUND
PMID: 32738937 (View on PubMed)

Lin FR, Ferrucci L, An Y, Goh JO, Doshi J, Metter EJ, Davatzikos C, Kraut MA, Resnick SM. Association of hearing impairment with brain volume changes in older adults. Neuroimage. 2014 Apr 15;90:84-92. doi: 10.1016/j.neuroimage.2013.12.059. Epub 2014 Jan 9.

Reference Type BACKGROUND
PMID: 24412398 (View on PubMed)

Cudmore V, Henn P, O'Tuathaigh CMP, Smith S. Age-Related Hearing Loss and Communication Breakdown in the Clinical Setting. JAMA Otolaryngol Head Neck Surg. 2017 Oct 1;143(10):1054-1055. doi: 10.1001/jamaoto.2017.1248.

Reference Type BACKGROUND
PMID: 28837709 (View on PubMed)

Pope DS, Gallun FJ, Kampel S. Effect of hospital noise on patients' ability to hear, understand, and recall speech. Res Nurs Health. 2013 Jun;36(3):228-41. doi: 10.1002/nur.21540. Epub 2013 Apr 19.

Reference Type BACKGROUND
PMID: 23606205 (View on PubMed)

Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet. 2014 Mar 8;383(9920):911-22. doi: 10.1016/S0140-6736(13)60688-1. Epub 2013 Aug 28.

Reference Type BACKGROUND
PMID: 23992774 (View on PubMed)

Oh ES, Fong TG, Hshieh TT, Inouye SK. Delirium in Older Persons: Advances in Diagnosis and Treatment. JAMA. 2017 Sep 26;318(12):1161-1174. doi: 10.1001/jama.2017.12067.

Reference Type BACKGROUND
PMID: 28973626 (View on PubMed)

Marcantonio ER. Delirium in Hospitalized Older Adults. N Engl J Med. 2017 Oct 12;377(15):1456-1466. doi: 10.1056/NEJMcp1605501.

Reference Type BACKGROUND
PMID: 29020579 (View on PubMed)

Fick DM, Steis MR, Waller JL, Inouye SK. Delirium superimposed on dementia is associated with prolonged length of stay and poor outcomes in hospitalized older adults. J Hosp Med. 2013 Sep;8(9):500-5. doi: 10.1002/jhm.2077. Epub 2013 Aug 19.

Reference Type BACKGROUND
PMID: 23955965 (View on PubMed)

Mohanty S, Gillio A, Lindroth H, Ortiz D, Holler E, Azar J, Boustani M, Zarzaur B. Major Surgery and Long Term Cognitive Outcomes: The Effect of Postoperative Delirium on Dementia in the Year Following Discharge. J Surg Res. 2022 Feb;270:327-334. doi: 10.1016/j.jss.2021.08.043. Epub 2021 Oct 29.

Reference Type BACKGROUND
PMID: 34731730 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

1K23AG065443-01

Identifier Type: NIH

Identifier Source: secondary_id

View Link

IRB00306862

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Gaining Insight Into Dual Sensory Loss
NCT06362213 NOT_YET_RECRUITING
Vocal Emotion Communication With Cochlear Implants
NCT05486637 RECRUITING EARLY_PHASE1