Clinical Research Directory

Inclusion Criteria: * Age 65 years or older. * Negative Confusion Assessment Method for the ICU (CAM-ICU) at the time of randomization. * Expected ICU length of stay of at least 48 hours based on clinical judgement at admission (e.g., need for mechanical ventilation, vasopressors, invasive monitoring). Exclusion Criteria: * Positive CAM-ICU prior to randomization. * Acute primary Central Nervous System pathology (e.g., ischemic or hemorrhagic stroke, traumatic brain injury, meningoencephalitis, intracranial hypertension) presenting with altered sensorium (Glasgow Coma Scale at admission \< 14) or focal deficit preventing cognitive assessment (e.g., severe aphasia). * Severe chronic cognitive impairment or advanced dementia, defined by a known history of severe functional dependence prior to admission (requiring permanent assistance for basic activities of daily living such as feeding or grooming) * Unresolved auditory or visual impairment. * Suspected or confirmed intoxication with drugs or alcohol at admission. * Uncontrolled psychiatric disease (at least one acute episode requiring intervention in the last 6 months). * Richmond Agitation-Sedation Scale (RASS) score \< -2 or \> +2 at the time of randomization. * Medical condition precluding the safe use of headphones (e.g., burns, skull fracture, skin lesions). * Inability to establish effective communication due to a language disorder or unresolved language barrier. * Inability of the patient or legal representative to provide informed consent. * Patients with imminent death, end-of-life care, or limitation of therapeutic effort.