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Clinical characteristics and risk factors of delirium in demented and not demented elderly medical inpatients.
J Nutr Health Aging 2006 Nov-Dec; 10(6):535-9JN

Abstract

OBJECTIVES

to evaluate the differences in clinical characteristics and risk factors of delirium in elderly medical inpatients according to the presence or not of dementia.

DESIGN

cross-sectional, observational study.

SETTING

acute medical care unit (ACU) of a general hospital.

PARTICIPANTS

330 patients aged 65 and older consecutively admitted on a 24-week period.

MEASUREMENTS

Functional status, cognitive abilities, severity of acute illness (Acute Physiology, Age and Chronic Health Evaluation (APACHE II) score), Confusion Assessment Method (CAM), Delirium Rating Scale (DRS) and One Day Fluctuation Scale (ODFS).

RESULTS

patients with delirium represent 19.1% of the sample, 41.0% of which had also dementia. Hyperactive form of delirium was 41.0%; hypoactive 11.0% and mixed 48.0%. In non demented patients, the delirious patients showed higher APACHE II score, more severe functional decline, poorer cognitive status respect to not delirious. In demented patients no differences were found in APACHE II score and cognitive status among delirious and not delirious subjects. In this group, functional decline (p = .012), acute infection (p = .007), psychotropic drugs use (p = .028) and severe hypoalbuminemia (p = .036) represented risk factors for the onset of delirium. Demented patients had higher perceptual disturbances (p = .040) and less severe delusions (p = .001), while total DRS score do not differs in the two groups. According to ODFS, delirium episode was more fluctuating in patients with dementia.

CONCLUSION

clinical characteristics and risk factors of delirium are different in demented and not demented elderly inpatients. Patients with dementia are vulnerable to delirium at lower levels of medical acuity than non-demented patients.

Authors+Show Affiliations

Department of Medicine, S Anna Hospital, Brescia, Italy.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17183425

Citation

Margiotta, A, et al. "Clinical Characteristics and Risk Factors of Delirium in Demented and Not Demented Elderly Medical Inpatients." The Journal of Nutrition, Health & Aging, vol. 10, no. 6, 2006, pp. 535-9.
Margiotta A, Bianchetti A, Ranieri P, et al. Clinical characteristics and risk factors of delirium in demented and not demented elderly medical inpatients. J Nutr Health Aging. 2006;10(6):535-9.
Margiotta, A., Bianchetti, A., Ranieri, P., & Trabucchi, M. (2006). Clinical characteristics and risk factors of delirium in demented and not demented elderly medical inpatients. The Journal of Nutrition, Health & Aging, 10(6), pp. 535-9.
Margiotta A, et al. Clinical Characteristics and Risk Factors of Delirium in Demented and Not Demented Elderly Medical Inpatients. J Nutr Health Aging. 2006;10(6):535-9. PubMed PMID: 17183425.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical characteristics and risk factors of delirium in demented and not demented elderly medical inpatients. AU - Margiotta,A, AU - Bianchetti,A, AU - Ranieri,P, AU - Trabucchi,M, PY - 2006/12/22/pubmed PY - 2007/3/16/medline PY - 2006/12/22/entrez SP - 535 EP - 9 JF - The journal of nutrition, health & aging JO - J Nutr Health Aging VL - 10 IS - 6 N2 - OBJECTIVES: to evaluate the differences in clinical characteristics and risk factors of delirium in elderly medical inpatients according to the presence or not of dementia. DESIGN: cross-sectional, observational study. SETTING: acute medical care unit (ACU) of a general hospital. PARTICIPANTS: 330 patients aged 65 and older consecutively admitted on a 24-week period. MEASUREMENTS: Functional status, cognitive abilities, severity of acute illness (Acute Physiology, Age and Chronic Health Evaluation (APACHE II) score), Confusion Assessment Method (CAM), Delirium Rating Scale (DRS) and One Day Fluctuation Scale (ODFS). RESULTS: patients with delirium represent 19.1% of the sample, 41.0% of which had also dementia. Hyperactive form of delirium was 41.0%; hypoactive 11.0% and mixed 48.0%. In non demented patients, the delirious patients showed higher APACHE II score, more severe functional decline, poorer cognitive status respect to not delirious. In demented patients no differences were found in APACHE II score and cognitive status among delirious and not delirious subjects. In this group, functional decline (p = .012), acute infection (p = .007), psychotropic drugs use (p = .028) and severe hypoalbuminemia (p = .036) represented risk factors for the onset of delirium. Demented patients had higher perceptual disturbances (p = .040) and less severe delusions (p = .001), while total DRS score do not differs in the two groups. According to ODFS, delirium episode was more fluctuating in patients with dementia. CONCLUSION: clinical characteristics and risk factors of delirium are different in demented and not demented elderly inpatients. Patients with dementia are vulnerable to delirium at lower levels of medical acuity than non-demented patients. SN - 1279-7707 UR - https://www.unboundmedicine.com/medline/citation/17183425/Clinical_characteristics_and_risk_factors_of_delirium_in_demented_and_not_demented_elderly_medical_inpatients_ L2 - https://medlineplus.gov/dementia.html DB - PRIME DP - Unbound Medicine ER -