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Delirium superimposed on dementia: a systematic review
Donna M Fick1, Joseph V Agostini, Sharon K Inouye
1Department of Medicine, Medical College of Georgia, Augusta, Georgia 30912, USA. dfick@mail.mcg.edu
Journal of the American Geriatrics Society
|October 9, 2002
Summary
Delirium superimposed on dementia is common in older adults, leading to poor outcomes like cognitive decline and increased mortality. Early recognition and prevention are crucial due to limited research on its management.
Area of Science:
- Geriatrics
- Neurology
- Psychiatry
Background:
- Delirium in patients with pre-existing dementia is a frequent clinical challenge.
- This condition carries significant complications and poor prognostic implications.
Purpose of the Study:
- To systematically review the medical literature on delirium superimposed on dementia.
- Focus on prevalence, associated features, outcomes, and management strategies.
Main Methods:
- Systematic literature review of 14 studies (prospective, retrospective, cross-sectional, clinical trials).
- MEDLINE search (1966-2002) using keywords: delirium, dementia, Alzheimer's disease, elderly.
- Inclusion criteria: data on delirium superimposed on dementia, validated definitions, primary data.
Main Results:
- Prevalence of delirium superimposed on dementia ranges from 22% to 89% in older adults with dementia.
- Adverse outcomes include accelerated cognitive/functional decline, institutionalization, rehospitalization, and increased mortality.
- Limited research exists on associated factors and interventions.
Conclusions:
- There is a significant dearth of research on delirium superimposed on dementia.
- Emphasizes the critical need for early recognition and prevention of delirium in individuals with dementia.