Phenomenological subtypes of delirium in older persons: patterns, prevalence, and prognosis

Psychosomatics. May-Jun 2009;50(3):248-54. doi: 10.1176/appi.psy.50.3.248.

Abstract

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Cross-Sectional Studies
  • Delirium / classification*
  • Delirium / diagnosis
  • Delirium / epidemiology*
  • Delirium / psychology
  • Female
  • Humans
  • Incidence
  • Longitudinal Studies
  • Male
  • Motor Activity*
  • Neuropsychological Tests
  • Prognosis
  • Psychomotor Disorders / classification*
  • Psychomotor Disorders / diagnosis
  • Psychomotor Disorders / epidemiology*
  • Psychomotor Disorders / psychology
  • Survival Rate