Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Nov 13:3:2333721417739188.
doi: 10.1177/2333721417739188. eCollection 2017 Jan-Dec.

Factors Related to the Severity of Delirium in the Elderly Patients With Infection

R A Tuty Kuswardhani  1 , Yosef Samon Sugi  1
Affiliations

Factors Related to the Severity of Delirium in the Elderly Patients With Infection

R A Tuty Kuswardhani et al. Gerontol Geriatr Med. .

Abstract

Objective: Delirium is a common neuropsychiatric syndrome in the elderly characterized by concurrent impairments in cognition and behavior. Infection is one of the most important risk factors for delirium. The objective of this study is to elaborate the factors related to the severity of delirium in the elderly patients with infection. Method: An observational study on the relationship of several clinical parameters and the severity of delirium in elderly patients (more than 60 years) with infection was conducted at Geriatric Inpatient Ward, Sanglah Hospital. Delirium was defined by the Memorial Delirium Assessment Scale (MDAS). Charlson Age Comorbidity Index (CACI) scores were calculated as proposed by Charlson et al. Infection was confirmed by clinical, laboratory, and radiographic findings. Results: During 3 months, there were 60 elderly patients (35 men and 25 women) who were hospitalized with infection and delirium. In all, 33 (55.0%), 16 (26.7%), and 11 (18.3%) patients had pneumonia, urinary tract infection, and other infections, respectively, and 44 out of 60 (73.3%) patients had sepsis. There was no significant difference found in MDAS score between male and female patients and among different types of infection, but patients with sepsis had higher MDAS score significantly compared with patients without sepsis (19.48 ± 3.72 vs. 15.88 ± 2.82; p < .001). This study revealed that of several clinical parameters, only CACI (R = .533; p < .001), blood urea nitrogen (BUN; R = .230; p = .040), and interleukin 6 (IL-6) levels (R = .499; p < .001) were correlated with MDAS score significantly. By multiple linear regression test, CACI, IL-6, and sepsis have significant role, meanwhile, BUN has no role, on the severity of delirium. Conclusions: The CACI score, IL-6 levels, and sepsis have strong relationship with the severity of delirium, but BUN only has weak role in the severity of delirium in the elderly patients with infection.

Keywords: delirium; elderly; infection.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: This paper was written independently. Both authors disclose no financial or personal relationships with other people or organizations that could inappropriately influence the work.

References

    1. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
    1. Balogun S. A., Philbrick J. T. (2014). Delirium, a symptom of UTI in the elderly: Fact or fable? A systematic review. Canadian Geriatrics Journal, 17(1), 22-26. - PMC - PubMed
    1. Breitbart W., Rosenfeld B., Roth A., Smith M. J., Gohen K., Passik S. (1997). The memorial Delirium Assessment Scale. Journal of Pain and Symptom Management, 13, 128-137. - PubMed
    1. Caplan G. (2011). Managing delirium in older patients. Australian Prescriber, 34, 16-18.
    1. Cerejeira J., Nogueira V., Luís P., Vaz-Serra A., Mukaetova-Ladinska E. B. (2012). The cholinergic system and inflammation: Common pathways in delirium pathophysiology. Journal of the American Geriatrics Society, 60, 669-675. - PubMed

LinkOut - more resources