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Delirium in Alzheimer disease
1Alzheimer Center, Department of Neurology, University Hospitals of Cleveland, Ohio, USA.
Alzheimer Disease and Associated Disorders
|March 1, 1997
Summary
Delirium is common in community-dwelling Alzheimer disease (AD) patients, often triggered by infections or stress. While not an initial AD symptom, delirium impacts daily living and behavioral symptoms more than cognition.
Area of Science:
- Gerontology
- Neurology
- Psychiatry
Background:
- Advanced age and dementia are established risk factors for delirium.
- Most delirium research focuses on hospitalized individuals, neglecting community-dwelling populations.
Purpose of the Study:
- To investigate the incidence and characteristics of delirium in community-dwelling patients with Alzheimer disease (AD).
- To identify factors associated with delirium onset and its impact on cognitive and functional status in AD patients.
Main Methods:
- Retrospective review of 199 community-dwelling AD patients.
- Matched comparison of patients with and without delirium episodes.
- Analysis of causes of delirium, cognitive scores (MMSE), dementia severity (CDR), functional status (ADL), education, neuropsychological performance, and behavioral symptoms (BPRS).
Main Results:
- 22% of AD patients experienced delirium during their illness; 3% had delirium as an initial AD symptom.
- Common delirium triggers included urinary tract infections, stressful events, surgery, medical illnesses, and medications.
- Patients with prior delirium episodes showed worse Activities of Daily Living (ADL) scores and increased hallucinations/delusions, but no significant cognitive differences compared to controls.
Conclusions:
- Delirium is a frequent complication in community-dwelling AD patients, occurring in various clinical contexts.
- Delirium is rarely the initial symptom of AD.
- Functional status (ADL) and behavioral symptoms are more sensitive indicators of delirium's impact in AD than cognitive measures.
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