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Prevalence of delirium among outpatients with dementia

Published online by Cambridge University Press:  22 July 2013

N. Hasegawa ,
M. Hashimoto ,
S. Yuuki ,
K. Honda ,
Y. Yatabe ,
K. Araki  and
M. Ikeda
N. Hasegawa
Affiliation:
Department of Psychiatry, Kobe University Graduate School of Medicine, Hyogo, Japan Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan Kumamoto Mental Health Hospital, Kumamoto, Japan
M. Hashimoto
Affiliation:
Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
S. Yuuki
Affiliation:
Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan Kumamoto Mental Health Hospital, Kumamoto, Japan
K. Honda
Affiliation:
Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
Y. Yatabe
Affiliation:
Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
K. Araki
Affiliation:
Kumamoto Mental Health Hospital, Kumamoto, Japan
M. Ikeda*
Affiliation:
Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan Kumamoto Mental Health Hospital, Kumamoto, Japan
*
Correspondence should be addressed to: Dr. Manabu Ikeda, MD, PhD, Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556, Japan. Phone: +81-96-373-5184; Fax: +81-96-373-5186. Email: mikeda@kumamoto-u.ac.jp.
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Abstract

Background:

Delirium and dementia are highly interrelated. However, few comprehensive epidemiological studies have examined this altered state of consciousness superimposed on dementia. We investigated the frequency of delirium in patients with dementia, its prevalence in patients with each dementia type, and its association with cerebrovascular disease (CVD) in patients with neurodegenerative dementias.

Methods:

We studied 261 consecutive outpatients in the memory clinic of a psychiatric hospital between April 2010 and September 2011. All patients underwent routine laboratory tests and computed tomography (CT), and their Mini-Mental State Examination, Neuropsychiatric Inventory (NPI), Physical Self-Maintenance Scale (PSMS), and Delirium Rating Scale – Revised 98 scores were recorded. The diagnosis of delirium was based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision. CVD was detected by CT.

Results:

Among the 206 patients with dementia, delirium was present in 40 (19.4%). The proportion of patients who experienced episodes of delirium was 14.7% in the Alzheimer's disease, 34.4% in the vascular dementia, 31.8% in the dementia with Lewy bodies, and none in frontotemporal lobar degeneration. Delirium was frequently observed in patients with dementia and CVD. The NPI total and agitation subscale scores were significantly higher in dementia patients with delirium than in those without delirium. PSMS scores were significantly lower for patients with delirium than for patients without delirium.

Conclusions:

The frequency of delirium varies with each dementia type. In addition, delirium decreases activities of daily living, exaggerates behavioral and psychological symptoms dementia, and is associated with CVD in patients with neurodegenerative dementias.

Keywords

deliriumdementiacerebrovascular diseasebehavioral and psychological symptoms of dementianeuropsychiatric inventory
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 11 , November 2013 , pp. 1877 - 1883
Copyright
Copyright © International Psychogeriatric Association 2013 

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