Delirium superimposed on dementia versus delirium in the absence of dementia: Phenomenological differences Journal Article


Authors: Boettger, S.; Passik, S.; Breitbart, W.
Article Title: Delirium superimposed on dementia versus delirium in the absence of dementia: Phenomenological differences
Abstract: Objective: To examine differences in the phenomenological characteristics of delirium superimposed on dementia compared to those observed in delirious patients without dementia, based on the rating items of the Memorial Delirium Assessment Scale (MDAS).Methods: We conducted an analysis of a prospectively collected clinical delirium database utilized to record and monitor the care of delirious patients treated at Memorial Sloan-Kettering Cancer Center (MSKCC). Sociodemographic, medical variables, and MDAS total score and individual item ratings were analyzed in respect to differences between delirium in the demented (DD) versus delirium in the nondemented (ND).Results: We were able to examine data collected on 100 delirious patients: 82 ND patients and 18 DD patients. Patients in the DD group, compared to the ND group, had significantly greater levels of disturbance of consciousness and impairments in all cognitive domains (i.e., orientation, short term memory, concentration, organization of thought process). Severe symptoms were more common in the DD group compared to the ND group on all the MDAS cognitive items as well as in disturbance of consciousness. There were no significant differences between the DD and ND groups in terms of presence or severity of hallucinations, delusions, psychomotor behavior, and sleepwake cycle disturbance.Significance of results: Delirium superimposed on dementia has phenomenological differences compared to delirium in the absence of dementia. There are no significant differences in the severity of hallucinations, delusions, psychomotor behavior, or sleepwake cycle disturbances. However, level of disturbance in consciousness (arousal and awareness) and impairments in multiple cognitive domains are significantly more severe in patients with delirium superimposed on dementia. © 2009 Cambridge University Press.
Keywords: adult; aged; aged, 80 and over; middle aged; young adult; prospective study; prospective studies; neoplasm; neoplasms; delirium; risk factors; risk factor; psychological aspect; delirium superimposed on dementia; dementia; phenomenology; comorbidity; psychological rating scale; psychiatric status rating scales
Journal Title: Palliative and Supportive Care
Volume: 7
Issue: 4
ISSN: 1478-9515
Publisher: Cambridge University Press  
Date Published: 2009-12-01
Start Page: 495
End Page: 500
Language: English
DOI: 10.1017/s1478951509990502
PUBMED: 19939312
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 2" - "Export Date: 30 November 2010" - "Source: Scopus"
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  1. William S Breitbart
    505 Breitbart
  2. Steven D Passik
    122 Passik