Short report
Delirium episode as a sign of undetected dementia among community
dwelling elderly subjects: a 2 year follow up study
Terhi Rahkonena b, Riitta Luukkainen-Markkulaa, Satu Paanilaa b, Juhani Siveniusa c, Raimo Sulkavab d
a Brain Research and
Rehabilitation Center Neuron, Kuopio, Finland, b Division of Geriatrics, Department of Public
Health and General Practice, University of Kuopio, PO Box 1627, 70211 Kuopio, Finland, c Department of Neurology and Neuroscience, d Kuopio
University Hospital, Finland
Correspondence to: Dr Terhi Rahkonen Terhi.Rahkonen{at}uku.fi
Received 7 February
2000 and in revised form 18 May 2000;
Accepted 19 June
2000
Cognitive decline is commonly stated as one of the main risk
factors for delirium. The aim was to assess the importance of a
delirium episode as a symptom of an underlying dementia among community
dwelling healthy elderly people in a prospective 2 year follow up
study. The study patients consisted of 51 people living at home and
older than 65 years of age, without severe underlying disorders
including diagnosed dementia, admitted consecutively as emergency cases
to hospital because of an acute delirious state and followed up for 2 years. The diagnosis of delirium and dementia were based on the
DSM-III-R criteria. The community dwelling patients were evaluated and
tested annually by a clinical investigator, a geriatric study nurse,
and a neuropsychologist. The medical records of the institutionalised
patients were also evaluated. Dementia was diagnosed immediately after
the assurance that delirium symptoms had subsided in 14 out of 51 subjects (27%) and the additional 14 subjects were diagnosed as being
demented during the 2 year follow up, 28 out of 51 patients
(55%) altogether. Alzheimer's disease or mixed dementia was diagnosed
in 14 out of 51 patients (27%), vascular dementia in 10 (20%), and
dementia with Lewy bodies in two (4%). One case of alcoholic dementia
and one case of a non-alcoholic hepatic encephalopathia were also
found. A delirium episode is often the first sign of dementia requiring
attention from medical and social professionals.
Keywords: delirium; dementia; elderly
© 2000 by Journal of Neurology, Neurosurgery, and Psychiatry
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