Circadian disturbances, anxiety and motor disturbances differentiate delirium superimposed on dementia from dementia-only

TL;DR

This study finds that sleep issues, anxiety, and motor problems help distinguish delirium on top of dementia from dementia alone.

Contribution

Identifies specific clinical indicators to differentiate delirium superimposed on dementia from dementia-only cases.

Findings

DSD patients had lower clock-drawing test scores compared to DO patients.

Anxiety and sleep/night-time behavior disturbances were more severe in DSD patients.

Motor subtypes can help identify patients at risk for delirium.

Abstract

To ensure adequate treatment, individuals with delirium superimposed on dementia (DSD) need to be differentiated reliably from those with dementia only (DO). Therefore, we aimed to examine the clinical indicators of DSD by assessing motor subtypes, cognitive performance and neuropsychiatric symptoms in DSD and DO patients.

Cross-sectional design with the Delirium-Motor-Subtyping Scale (DMSS), Mini-Mental-State-Examination (MMSE), Clock-Drawing-Test (CDT), DemTect, and Neuropsychiatric Inventory assessed after admission to an acute hospital.

94 patients were included, 43 with DSD (78 ± 7 years, MMSE = 11 ± 9) and 51 with DO (79 ± 7 years, MMSE = 9 ± 8). DMSS “no subtype” was more common in the DO group (26% vs. 10%, p = .04). The DSD group showed lower CDT scores (DSD: M = 4 ± 3 vs. DO: M = 6 ± 1; p < .001) and higher anxiety (DSD: MED = 3 ± 8 vs. DO: MED = 3 ± 4; p = .01) and sleep/night-time behavior disturbances (DSD: MED = 0 ± 6 vs. DO: MED = 0 ± 0; p = .02).

Sleep/night-time behavior disturbances appear to be a clinical indicator of DSD. Motor subtypes can identify cases at increased risk of developing delirium or unrecognized delirium.

https://drks.de/search/de/trial/DRKS00025439, identifier DRKS00025439.

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