Delirium and right-hemisphere dysfunction in cognitively impaired older persons.
Cognitive impairment has been repeatedly shown to be a delirium risk factor. Much indirect evidence suggests that right-hemisphere dysfunction plays a particularly important role. This retrospective, case-controlled study, from a 148-patient memory loss clinic database, compared neuropsychological measures of hemispheric function in cognitively impaired elderly veterans with and without a history of delirium. Eleven study subjects had a history compatible with DSM-III-R criteria for delirium. Controls selected from the same database had no known history of delirium and were matched for Mini-Mental State Examination scores and Geriatric Depression Scale scores. Compared to the controls, subjects with a history of delirium had significantly lower scores on Object Assembly and Visual Reproduction (p < .05), tests that are predominantly right-hemisphere dependent. There were no significant differences in left-hemisphere measures. It is concluded that right-hemisphere dysfunction may prove to be an important risk factor for delirium.
Mach
J R
JR
Geriatric Research, Education, and Clinical Center, VA Medical Center, Minneapolis, Minnesota, USA.
Kabat
V
V
Olson
D
D
Kuskowski
M
M
D000368:Aged; D000369:Aged, 80 and over; D001288:Attention / Q000502:physiology; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000503:physiopathology; D003693:Delirium / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D003704:Dementia / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D004292:Dominance, Cerebral / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed