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. 2024 Aug 22:15:1407213.
doi: 10.3389/fpsyt.2024.1407213. eCollection 2024.

Circadian disturbances, anxiety and motor disturbances differentiate delirium superimposed on dementia from dementia-only

Thiemo Schnorr  1   2 , Tim Fleiner  1   2   3 , Rieke Trumpf  1   2 , Christian Prüter-Schwarte  4 , Janina Fanselow  1 , Wiebren Zijlstra  2 , Peter Haussermann  1
Affiliations

Circadian disturbances, anxiety and motor disturbances differentiate delirium superimposed on dementia from dementia-only

Thiemo Schnorr et al. Front Psychiatry. .

Abstract

Background: To ensure adequate treatment, individuals with delirium superimposed on dementia (DSD) need to be differentiated reliably from those with dementia only (DO). Therefore, we aimed to examine the clinical indicators of DSD by assessing motor subtypes, cognitive performance and neuropsychiatric symptoms in DSD and DO patients.

Methods: Cross-sectional design with the Delirium-Motor-Subtyping Scale (DMSS), Mini-Mental-State-Examination (MMSE), Clock-Drawing-Test (CDT), DemTect, and Neuropsychiatric Inventory assessed after admission to an acute hospital.

Results: 94 patients were included, 43 with DSD (78 ± 7 years, MMSE = 11 ± 9) and 51 with DO (79 ± 7 years, MMSE = 9 ± 8). DMSS "no subtype" was more common in the DO group (26% vs. 10%, p = .04). The DSD group showed lower CDT scores (DSD: M = 4 ± 3 vs. DO: M = 6 ± 1; p < .001) and higher anxiety (DSD: MED = 3 ± 8 vs. DO: MED = 3 ± 4; p = .01) and sleep/night-time behavior disturbances (DSD: MED = 0 ± 6 vs. DO: MED = 0 ± 0; p = .02).

Conclusions: Sleep/night-time behavior disturbances appear to be a clinical indicator of DSD. Motor subtypes can identify cases at increased risk of developing delirium or unrecognized delirium.

Clinical trial registration: https://drks.de/search/de/trial/DRKS00025439, identifier DRKS00025439.

Keywords: acute hospital; delirium superimposed on dementia; motor subtypes; neuropsychiatric symptoms; sleep disturbances.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study flowchart.
Figure 2
Figure 2
Total NPI incidence in DSD and DO group. *Delirium superimposed on dementia > dementia only at p <. 05.
See this image and copyright information in PMC

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