Outcome of delirium: part 2. Clinical features of reversible cognitive dysfunction--are they the same as accepted definitions of delirium?

Int J Geriatr Psychiatry. 1997 Jun;12(6):614-8. doi: 10.1002/(sici)1099-1166(199706)12:6<614::aid-gps1553>3.0.co;2-x.


Objective: To describe the clinical features of reversible cognitive dysfunction.

Design: Prospective cohort study.

Setting: Acute geriatric inpatient units.

Patients: A random sample of consecutive acute admissions of patients over the age of 65 (N = 80).

Main measurements: Serial assessments of mental state and cognitive function and observational data.

Outcome measure: Patients with more than five points of 20% improvement in Mini Mental State Examination following the most severely impaired assessment operationally designated 'reversible cognitive dysfunction'. The clinical features of those with RCD are compared with those with non-reversible cognitive dysfunction.

Main results: Delusions, hallucinations, aggression, excitement, irritability and other 'active' symptoms were not commoner in RCD than in non-reversible cognitive dysfunction (non-RCD). By contrast, 'quiet' signs, such as plucking at bedclothes, poor attention, incoherent speech, abnormal associations, slow, vague thought and fluctuating mental state were more marked in RCD than in non-RCD.

Conclusions: Reversible cognitive dysfunction is a quiet and unobtrusive disorder.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acting Out
  • Aged
  • Aged, 80 and over
  • Chi-Square Distribution
  • Confidence Intervals
  • Delirium / diagnosis
  • Delirium / physiopathology*
  • Dementia / diagnosis
  • Diagnosis, Differential
  • Diagnostic Errors
  • Female
  • Geriatric Assessment / statistics & numerical data*
  • Humans
  • Inpatients / classification*
  • Inpatients / psychology
  • Male
  • Prospective Studies
  • Remission, Spontaneous
  • Sampling Studies
  • Terminology as Topic*