scholarly journals Management of delirium superimposed on dementia in a dementia service

2020 ◽  
Vol 24 (4) ◽  
pp. 22-24
Author(s):  
James FitzGerald ◽  
Matthew Yan ◽  
Anuya Bandecar ◽  
Vamini Ratnasabapathy ◽  
Judy Rubinsztein ◽  
...  
Keyword(s):  
Delirium Superimposed On Dementia

Care for delirium superimposed on dementia at an early stage

2020 ◽  
Keyword(s):  
Behavioral Problems ◽  
Healthcare Professionals ◽  
Early Stage ◽  
Good Care ◽  
Structured Interviews ◽  
Ethical Considerations ◽  
Appropriate Care ◽  
Adequate Care ◽  
Insight Into ◽  
Delirium Superimposed On Dementia

Delirium is a common serious complication in dementia that is associated with poor prognosis and a high burden on caregivers and healthcare professionals. Appropriate care is therefore important at an early stage for patients with delirium superimposed on dementia To gain insight into the care of six patients with delirium superimposed on dementia, 19 semi-structured interviews were conducted focused on the experiences of caregivers and professionals. The interviews revealed four themes that appeared to play a role: 1. experiences with and views on behavioral problems of these patients, 2. recognition and diagnosis of delirium in dementia, 3. views on good care and 4. organizational aspects. Knowledge gaps about delirium in dementia, as well as ethical considerations, play an important role in organizing timely and adequate care for patients with delirium superimposed on dementia.

scholarly journals Impairments in balance and mobility identify delirium in patients with comorbid dementia

2018 ◽  
Vol 31 (5) ◽  
pp. 749-753 ◽  
Author(s):  
Neus Gual ◽  
Sarah J. Richardson ◽  
Daniel H. J. Davis ◽  
Giuseppe Bellelli ◽  
Wolfgang Hasemann ◽  
...  
Keyword(s):  
Motor Function ◽  
Mini Mental State Examination ◽  
The Elderly ◽  
Motor Dysfunction ◽  
Cross Sectional ◽  
Dsm 5 ◽  
Hierarchical Assessment ◽  
State Examination ◽  
Rehabilitation Hospitals ◽  
Delirium Superimposed On Dementia

ABSTRACTDiagnosing delirium superimposed on dementia (DSD) remains challenging because of a lack of specific tools, though motor dysfunction in delirium has been relatively under-explored. This study aimed to use dysfunction in balance and mobility (with the Hierarchical Assessment of Balance And Mobility: HABAM) to identify DSD. This is a cross-sectional multicenter study, recruiting consecutive patients ≥70 years admitted to five acute or rehabilitation hospitals in Ireland, Italy, Portugal, and Switzerland. Delirium was diagnosed using DSM-5 criteria; dementia was determined by the Mini-Mental State Examination and the Questionnaire of Cognitive Decline in the Elderly. HABAM score was recorded at admission. Out of 114 patients (mean age ± SD = 82 ± 7; 54% female), dementia alone was present in 24.6% (n = 28), delirium alone in 18.4% (n = 21) and DSD in 27.2% (n = 31). Patients with DSD had a mean HABAM score 7 points greater than those with dementia alone (19.8 ± 8.7 vs 12.5 ± 9.5; p < 0.001); 70% of participants with DSD were correctly identified using the HABAM at a cut off of 22 (sensitivity 61%, specificity 79%, AUC = 0.76). Individuals with delirium have worse motor function than those without delirium, even in the context of comorbid dementia. Measuring motor function using the HABAM in older people at admission may help to diagnose DSD.

Pilot Study of a Nonpharmacological Intervention for Delirium Superimposed on Dementia

2010 ◽  
Vol 4 (3) ◽  
pp. 161-167 ◽  
Author(s):  
Ann M. Kolanowski ◽  
Donna M. Fick ◽  
Linda Clare ◽  
Melinda Steis ◽  
Malaz Boustani ◽  
...  
Keyword(s):  
Pilot Study ◽  
Nonpharmacological Intervention ◽  
Delirium Superimposed On Dementia

Preliminary investigation of predictors of distress in informal caregivers of patients with delirium superimposed on dementia

2019 ◽  
Vol 32 (2) ◽  
pp. 339-344 ◽  
Author(s):  
Eleonora Grossi ◽  
Elena Lucchi ◽  
Simona Gentile ◽  
Marco Trabucchi ◽  
Giuseppe Bellelli ◽  
...  
Keyword(s):  
Preliminary Investigation ◽  
Informal Caregivers ◽  
Delirium Superimposed On Dementia

scholarly journals Neurovascular and immune mechanisms that regulate postoperative delirium superimposed on dementia

2020 ◽  
Vol 16 (5) ◽  
pp. 734-749 ◽  
Author(s):  
Ping Wang ◽  
Ravikanth Velagapudi ◽  
Cuicui Kong ◽  
Ramona M. Rodriguiz ◽  
William C. Wetsel ◽  
...  
Keyword(s):  
Postoperative Delirium ◽  
Immune Mechanisms ◽  
Delirium Superimposed On Dementia

scholarly journals Detecting delirium superimposed on dementia: diagnostic accuracy of a simple combined arousal and attention testing procedure

2017 ◽  
Vol 29 (10) ◽  
pp. 1585-1593 ◽  
Author(s):  
Sarah J. Richardson ◽  
Daniel H. J. Davis ◽  
Giuseppe Bellelli ◽  
Wolfgang Hasemann ◽  
David Meagher ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Medical Records ◽  
Clinical Utility ◽  
The Elderly ◽  
Testing Procedure ◽  
Cognitive Tests ◽  
Attention Task ◽  
High Diagnostic Accuracy ◽  
Eye Opening ◽  
Delirium Superimposed On Dementia

ABSTRACTBackground:Detecting delirium superimposed on dementia (DSD) can be challenging because assessment partly relies on cognitive tests that may be abnormal in both conditions. We hypothesized that a combined arousal and attention testing procedure would accurately detect DSD.Methods:Patients aged ≥70 years were recruited from five hospitals across Europe. Delirium was diagnosed by physicians using DSM-5 criteria using information from nurses, carers, and medical records. Dementia was ascertained by the Informant Questionnaire on Cognitive Decline in the Elderly. Arousal was measured using the Observational Scale of Level of Arousal (OSLA), which assesses eye opening, eye contact, posture, movement, and communication. Attention was measured by participants signaling each time an “A” was heard when “S-A-V-E-A-H-A-A-R-T” was read out.Results:The sample included 114 persons (mean age 82 years (SD 7); 54% women). Dementia alone was present in 25% (n = 28), delirium alone in 18% (n = 21), DSD in 27% (n = 31), and neither in 30% (n = 34). Arousal and attention was assessed in n = 109 (96%). Using OSLA, 83% participants were correctly identified as having delirium (sensitivity 85%, specificity 82%, AUROC 0.92). The attention task correctly classified 76% of participants with delirium (sensitivity 90%, specificity 64%, AUROC 0.80). Combining scores correctly classified 91% of participants with delirium (sensitivity 84%, specificity 92%, AUROC 0.94). Diagnostic accuracy remained high in the subgroup with dementia (93% correctly classified, sensitivity 94%, specificity 92%, AUROC 0.98).Conclusions:This combined arousal–attention assessment to detect DSD was brief yet had high diagnostic accuracy. Such an approach could have clinical utility for diagnosing DSD.

Prevalence and Symptoms of Delirium Superimposed on Dementia

2006 ◽  
Vol 15 (1) ◽  
pp. 46-66 ◽  
Author(s):  
Philippe Voyer ◽  
Martin G. Cole ◽  
Jane McCusker ◽  
Éric Belzile
Keyword(s):  
Delirium Superimposed On Dementia

Relationship between delirium and behavioral symptoms of dementia

2012 ◽  
Vol 25 (4) ◽  
pp. 635-643 ◽  
Author(s):  
Philippe Landreville ◽  
Philippe Voyer ◽  
Pierre-Hugues Carmichael
Keyword(s):  
Sleep Problems ◽  
Psychological Symptoms ◽  
Current Knowledge ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Behavioral Symptoms ◽  
Behavioral Disturbances ◽  
Diagnosis Of Dementia ◽  
Cognitive Problems ◽  
Delirium Superimposed On Dementia

ABSTRACTBackground: Persons with dementia frequently present behavioral and psychological symptoms as well as delirium. However, the association between these has received little attention from researchers and current knowledge in this area is limited. The purpose of this study was to examine the relation between delirium and behavioral symptoms of dementia (BSD).Methods: Participants were 155 persons with a diagnosis of dementia, 109 (70.3%) of whom were found delirious according to the Confusion Assessment Method. BSD were assessed using the Nursing Home Behavior Problem Scale.Results: Participants with delirium presented significantly more BSD than participants without delirium. More specifically, they presented more wandering/trying to leave, sleep problems, and irrational behavior after controlling for cognitive problems and use of antipsychotics and benzodiazepines. Most relationships between participant characteristics and BSD did not differ according to the presence or absence of delirium, but some variables, notably sleep problems, were more strongly associated to BSD in persons with delirium.Conclusions: Although correlates of BSD in persons with delirium superimposed on dementia are generally similar to those in persons with dementia alone, delirium is associated with a higher level of BSD. Results of this study have practical implications for the detection of delirium superimposed on dementia, the management of behavioral disturbances in patients with delirium, and caregiver burden.

When dementia and delirium come together

2019 ◽  
Vol 15 (6) ◽  
pp. 288-294
Author(s):  
Angela Moore ◽  
Karen Harrison Dening
Keyword(s):  
Social Care ◽  
Common Factors ◽  
Care Staff ◽  
Community Settings ◽  
Health And Social Care ◽  
Effective Training ◽  
Diagnosis Of Dementia ◽  
The Common ◽  
Cognitively Intact ◽  
Delirium Superimposed On Dementia

Delirium is a multifactorial syndrome that, when superimposed on dementia, can lead to twice the risk of being admitted to acute care than for a person who is cognitively intact. Early detection of delirium can be a challenge, especially when there is an existing diagnosis of dementia. Despite the wealth of literature, there continues to be a widespread lack of knowledge about delirium, and under-detection in all types of health and social care settings. This lack of recognition may lead to poor health outcomes and increased mortality. There is a need for effective training for staff working in community settings, and effective communication between health and social care staff and families who are affected by delirium. Furthermore, delirium superimposed on dementia is common, and may cause distress for patients, caregivers and staff. This article will explore some of the common factors when delirium is comorbid with dementia.

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