Treatment characteristics of delirium superimposed on dementia Journal Article


Authors: Boettger, S.; Passik, S.; Breitbart, W.
Article Title: Treatment characteristics of delirium superimposed on dementia
Abstract: Background: The course of delirium in patients with dementia who are undergoing management of delirium with antipsychotics has not previously been studied. In order to investigate the treatment characteristics of patients with delirium superimposed on dementia in contrast to delirium in the absence of dementia we performed a secondary analysis of our delirium database. Methods: We collected sociodemographic data and medical variables in addition to using the systematic rating scales of the Memorial Delirium Assessment Scale (MDAS) and Karnofsky Scale of Performance Status (KPS). These data were recorded in the delirium database. For this analysis we extracted all data pertaining to patients with delirium and dementia (DD) and compared them to those with delirium without dementia (i.e. non-demented with delirium; NDD). Results: Out of 111 cases with a diagnosis of delirium we acquired 22 cases with a diagnosis of DD and 89 cases with NDD. The mean age was significantly different with 77.1 years for DD and 62.7 years for NDD. The MDAS scores at baseline were significantly higher in DD (21.1) compared to NDD (17.6). Over the course of treatment, MDAS scores were significantly higher in DD with 11.7 at T3 compared with 7.0 in NDD. After three days of management, delirium resolution rates were significantly lower in DD with 18.2% compared to 53.9% in NDD, and at seven days delirium resolution rates were 50% and 83% respectively. At the endpoint of the observation period, DD had a significantly more pronounced disturbance of consciousness and impairment in the cognitive domain. KPS scores were not significantly different between DD and NDD. Conclusion: In our sample of patients with delirium superimposed on dementia the delirium resolution rates were lower than in patients without dementia at one week of treatment. The data suggest that when delirium is superimposed on dementia the delirium may resolve at a slower rate. © Copyright International Psychogeriatric Association 2011.
Keywords: adult; controlled study; treatment outcome; aged; aged, 80 and over; middle aged; major clinical study; treatment duration; diagnosis, differential; aripiprazole; haloperidol; olanzapine; risperidone; delirium; risk factors; karnofsky performance status; delirium superimposed on dementia; dementia; comorbidity; psychological rating scale; psychiatric status rating scales; sampling studies; aging; cognitive defect; geriatric patient; clinical observation; psychopharmacotherapy; cognitive disorder; memorial delirium assessment scale; consciousness disorder; treatment characteristics
Journal Title: International Psychogeriatrics
Volume: 23
Issue: 10
ISSN: 1041-6102
Publisher: Cambridge University Press  
Date Published: 2011-12-01
Start Page: 1671
End Page: 1676
Language: English
DOI: 10.1017/s1041610211000998
PROVIDER: scopus
PUBMED: 21729412
DOI/URL:
Notes: --- - "Export Date: 9 December 2011" - "CODEN: INPSE" - "Source: Scopus"
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  1. William S Breitbart
    505 Breitbart
  2. Steven D Passik
    122 Passik