Cognitive Intervention For Delirium in Dementia

The primary aim in this RCT is to test the efficacy of Recreational Stimulation for Elders
as a Vehicle to resolve DSD (RESERVE- DSD). The investigators will randomize 256 subjects,
newly admitted to post acute care, to intervention (RESERVE-DSD) or control (usual care).
Intervention subjects will receive 30-minute sessions of tailored cognitively stimulating
recreational activities for up to 30 days. The investigators hypothesize that subjects who
receive RESERVE-DSD will have: decreased severity and duration of delirium; greater gains in
attention, orientation, memory, abstract thinking, and executive functioning; and greater
gains in physical function compared to subjects with DSD who receive usual care. The
investigators will also evaluate potential moderators of intervention efficacy (lifetime of
complex mental activities and APOE status). The secondary aim is to describe the costs
associated with RESERVE-DSD.

Inclusion Criteria:

- presence of delirium

- mild to moderate cognitive impairments

- 65 years of age or older

- English speaking

- community-dwelling

- legally authorized representative available

Exclusion Criteria:

- severe vision or hearing problems

- diagnosis of

1. major depression

2. Parkinson's with Lewy Body disease

3. Huntington's disease

4. normal pressure hydrocephalus

5. seizure disorder

6. subdural hematoma

7. head trauma

8. known structural brain abnormalities

9. acute CVA/stroke

10. acute psychiatric condition

- life expectancy < 6 months