[Early diagnosing of delirium in the elderly with acute stroke]

Delirium is a common complication of stroke worsening its prognosis. The aim of the work is to identify the group of risk for the development of delirium among elderly patients with acute stroke and assessment of diagnostic value of 4-A test in identifying delirium in this category of patients. We included 73 patients in the study, 33 (45 %) of which had symptoms of delirium according to DSM-IV. Patients with delirium had more severe neurological deficit, more prominent chronic changes on brain CT, more often had positive axial reflexes, had higher erythrocyte sedimentation rate. All patients with pneumonia were delirious. Russian version of 4-A test showed good psychometric properties. Thus the risk of the development of delirium in older adults with acute stroke is higher among patients with severe strokes, more prominent chronic changes in the brain according to CT and clinical examination and in those with inflammatory complications. Purposeful screening of the patients with aforementioned risk factors with instruments such as 4-AT will allow more efficient and fast diagnosing of delirium on early stages in the elderly with acute stroke.