Melatonin and melatonin-receptor agonists to prevent delirium in hospitalized older adults: An umbrella review.

Journal Article (Review;Journal Article)


Alterations in circadian rhythm play an important role in the development of delirium. In this umbrella review, we examined the efficacy of melatonin and ramelteon for delirium prevention in hospitalized older adults.


Umbrella review methodology from the Joanna Briggs Institute guided the review process. Only meta-analyses were included. Risk of bias was evaluated using the AMSTAR-2 checklist.


Three meta-analyses were included in this review. The quality of studies was low-to-moderate. Two meta-analyses reported a significant reduction in delirium using melatonin or ramelteon (pooled OR and 95% confidence intervals ranged from 0.41 [0.19-0.86] to 0.63 [0.46-0.87]). Melatonergics significantly reduced delirium on medical units (OR = 0.25, 95% CI 0.07-0.88) but not surgical units (OR = 0.62, 0.16-2.43). Heterogenity was high, with I2 ranging from 72.14% to 84%.


Melatonergics appear to prevent delirium among hospitalized older adults, particularly those on medical units. Based on these results, providers may consider using melatonergics as complements to high-quality multicomponent delirium prevention.

Full Text

Duke Authors

Cited Authors

  • Blodgett, TJ; Blodgett, NP

Published Date

  • November 5, 2021

Published In

Volume / Issue

  • 42 / 6

Start / End Page

  • 1562 - 1568

PubMed ID

  • 34749057

Electronic International Standard Serial Number (EISSN)

  • 1528-3984

International Standard Serial Number (ISSN)

  • 0197-4572

Digital Object Identifier (DOI)

  • 10.1016/j.gerinurse.2021.10.011


  • eng