Clinical profile of delirium in older patients

J Am Geriatr Soc. 1999 Nov;47(11):1300-6. doi: 10.1111/j.1532-5415.1999.tb07429.x.


Objective: To examine the prevalence, psychiatric and behavior symptoms, differing symptom profiles, and diurnal variations of delirium in older patients.

Design: A descriptive, point prevalence study with a cross-sectional design.

Setting: One ordinary county hospital (n = 148), three nursing homes (n = 202), five old people's homes (n = 196), and home medical care patients (n = 171) in parts of a hospital catchment area in Mid-Sweden.

Participants: A total of 717 patients 75 years of age and older were observed and assessed for the prevalence of delirium. Women accounted for 66.4% of the studied population, and the mean age for both sexes was 83.7 years.

Measurements: All patients were examined using the OBS (Organic Brain Syndrome) scale, and delirium was diagnosed according to DSM-III-R.

Results: Delirium was diagnosed in 315 of 717 (43.9%) patients, and 135 of 315 (42.9%) of the delirious patients had dementia. Thirty-seven percent of the patients with delirium were delirious in the afternoon, evening, or at night, and 47% of the delirious patients had morning delirium. The delirious patients presented a wide variety of psychiatric symptoms. More than half the patients exhibiting anxiety, psychomotor slowing, depressed mood, and irritability. Nearly 26% were classified as having hypoactive, 22% as having hyperactive, and 42% as having mixed delirium, whereas 11% had neither hypo- nor hyperactive delirium. Seventy-seven percent were classified as having delirium with pronounced emotional and 43% with pronounced psychotic symptoms.

Conclusions: This study shows that patients with delirium have very different clinical profiles. This might indicate a need for different treatment strategies for patients with different types of delirium.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Affective Symptoms / psychology
  • Aged
  • Aged, 80 and over
  • Anxiety / psychology
  • Circadian Rhythm
  • Cross-Sectional Studies
  • Delirium / diagnosis
  • Delirium / physiopathology
  • Delirium / psychology*
  • Dementia / psychology
  • Depression / psychology
  • Female
  • Humans
  • Irritable Mood / physiology
  • Male
  • Prevalence
  • Psychomotor Disorders / psychology
  • Psychotic Disorders / psychology