Acute confusional state in patients with and without dementia

Among 1029 geriatric consultations in a comprehensive geriatric hospital unit, 69 had an acute confusional state (6.7%) of whom 32 had dementia. Acute confusional state was the initial presentation in 17 (53%) of those with dementia There were no differences between these two dementia subgroups in any of the baseline variables. The two subgroups were combined for further analysis against the non-dementia group. The mean age in the dementia group was lower (79 years+/-6.8) than in the non-dementia group (84 years+/-8.5) but this was not significant (P<0.32) and 78% of the patients in latter group were males (P<0.03). The aetiological factors were not significantly different in the two groups. There were six deaths, five from the non-dementia group with a mean age of 80 years (range 74-89). There was no difference between groups in the final disposition (P<0.21) and more than half in each group required placement in a long term nursing care facility. The functional disability following acute confusional state had an important impact on caregivers in both groups perhaps even exceeding that of cognitive decline and was a significant factor for institutionalisation.