Outcome of delirium: part 2. Clinical features of reversible cognitive dysfunction--are they the same as accepted definitions of delirium?
OBJECTIVE
To describe the clinical features of reversible cognitive dysfunction.


METHODS
Prospective cohort study.


METHODS
Acute geriatric inpatient units.


METHODS
A random sample of consecutive acute admissions of patients over the age of 65 (N = 80).


METHODS
Serial assessments of mental state and cognitive function and observational data.


METHODS
Patients with more than five points of 20% improvement in Mini Mental State Examination following the most severely impaired assessment operationally designated 'reversible cognitive dysfunction'. The clinical features of those with RCD are compared with those with non-reversible cognitive dysfunction.


RESULTS
Delusions, hallucinations, aggression, excitement, irritability and other 'active' symptoms were not commoner in RCD than in non-reversible cognitive dysfunction (non-RCD). By contrast, 'quiet' signs, such as plucking at bedclothes, poor attention, incoherent speech, abnormal associations, slow, vague thought and fluctuating mental state were more marked in RCD than in non-RCD.


CONCLUSIONS
Reversible cognitive dysfunction is a quiet and unobtrusive disorder.
Treloar
A J
AJ
Section of Old Age Psychiatry, UMDS (Guy's) Bexley, UK.
Macdonald
A J
AJ
D000184:Acting Out; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D003693:Delirium / Q000175:diagnosis / Q000503:physiopathology*; D003704:Dementia / Q000175:diagnosis; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients / Q000145:classification* / Q000523:psychology; D008297:Male; D011446:Prospective Studies; D012075:Remission, Spontaneous; D012494:Sampling Studies; D009626:Terminology as Topic