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.
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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Authors: Charles H Brown; Andrew LaFlam; Laura Max; Julie Wyrobek; Karin J Neufeld; Khaled M Kebaish; David B Cohen; Jeremy D Walston; Charles W Hogue; Lee H Riley Journal: J Am Geriatr Soc Date: 2016-10-03 Impact factor: 5.562