Phenomenological subtypes of delirium in older persons: patterns, prevalence, and prognosis.
BACKGROUND
Delirium is an acute confusional state that is common, preventable, and life-threatening.


OBJECTIVE
The authors investigated the phenomenology of delirium severity as measured with the Memorial Delirium Assessment Scale among 441 older patients (age 65 and older) admitted with delirium in post-acute care.


METHODS
Using latent class analysis, they identified four classes of psychomotor-severity subtypes of delirium: 1) hypoactive/mild; 2) hypoactive/severe; 3) mixed, with hyperactive features/severe; and 4) normal/mild.


RESULTS
Among those with dementia (N=166), the hypoactive/mild class was associated with a higher risk of mortality. Among those without dementia (N=275), greater severity was associated with mortality, regardless of psychomotor features, when compared with the normal/mild class.


CONCLUSIONS
The data suggest that instruments measuring delirium severity and psychomotor features provide important prognostic information and should be integrated into the assessment of delirium.
Yang
Frances M
FM
Institute for Aging Research, Hebrew SeniorLife, 1200 Centre Street, Boston, MA 02131, USA. francesyang@hrca.harvard.edu
Marcantonio
Edward R
ER
Inouye
Sharon K
SK
Kiely
Dan K
DK
Rudolph
James L
JL
Fearing
Michael A
MA
Jones
Richard N
RN
D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003693:Delirium / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D009043:Motor Activity; D009483:Neuropsychological Tests; D011379:Prognosis; D011596:Psychomotor Disorders / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015996:Survival Rate