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Published on: December 18, 2016
Phenomenological subtypes of delirium in older persons: patterns, prevalence, and prognosis
Frances M Yang1, Edward R Marcantonio, Sharon K Inouye
1Institute for Aging Research, Hebrew SeniorLife, 1200 Centre Street, Boston, MA 02131, USA. francesyang@hrca.harvard.edu
Background:
Delirium is an acute confusional state that is common, preventable, and life-threatening.
Objective:
The authors investigated the phenomenology of delirium severity as measured with the Memorial Delirium Assessment Scale among 441 older patients (age 65 and older) admitted with delirium in post-acute care.
Methods:
Using latent class analysis, they identified four classes of psychomotor-severity subtypes of delirium: 1) hypoactive/mild; 2) hypoactive/severe; 3) mixed, with hyperactive features/severe; and 4) normal/mild.
Results:
Among those with dementia (N=166), the hypoactive/mild class was associated with a higher risk of mortality. Among those without dementia (N=275), greater severity was associated with mortality, regardless of psychomotor features, when compared with the normal/mild class.
Conclusion:
The data suggest that instruments measuring delirium severity and psychomotor features provide important prognostic information and should be integrated into the assessment of delirium.
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