title: Delirium in elderly people: a study of a psychiatric liaison service in north India.
abstract: BACKGROUND
  Very few studies from India have studied the phenomenology of delirium. The aim of the present study was to study the phenomenology as measured using the Delirium Rating Scale-Revised-98 (DRS-R98), the associated etiologies and the outcome of delirium among the elderly participants seen by the consultation-liaison psychiatric service in India. In addition, an attempt was made to study the factor structure of symptoms using principal components analysis.
  
  
  METHODS
  The case notes of 109 elderly patients referred to psychiatry liaison services were reviewed.
  
  
  RESULTS
  The mean age of the sample was 73.35 years (SD: 7.44; range 65-95 years) and two-thirds of the sample had hospital emergent delirium. The mean DRS-R98 severity score was 18.77 and the DRS-R98 total score was 24.81. In 15 patients the DRS-R98 scores were in the subsyndromal range. Among the various symptoms present, most patients had sleep-wake cycle disturbance, disturbance in orientation, attention and short-term memory impairments, fluctuation of symptoms, temporal onset of symptoms and a physical disorder. Principal components analysis identified three factors which explained 43.5% of variance of symptomatology and it yielded a three-factor structure. Endocrine/metabolic disturbances were the commonest associated etiological category with delirium. The mean hospital stay after being referred to psychiatry referral services was 8.89 days, after which delirium improved in 58.7% of cases. The mortality rate during the inpatient stay was 16.5%.
  
  
  CONCLUSIONS
  Results suggest that the symptoms of delirium as assessed by DRS-R98 separate out into a three-factor structure. Delirium is commonly associated with metabolic endocrine disturbances and about one-sixth of the patients die during the short inpatient stay.
authors.affiliation: Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India. drsandeepg2002@yahoo.com
authors.forename: Sandeep
authors.initials: S
authors.lastname: Grover
authors.forename: Natasha
authors.initials: N
authors.lastname: Kate
authors.forename: Munish
authors.initials: M
authors.lastname: Agarwal
authors.forename: Surendra Kumar
authors.initials: SK
authors.lastname: Mattoo
authors.forename: Ajit
authors.initials: A
authors.lastname: Avasthi
authors.forename: Savita
authors.initials: S
authors.lastname: Malhotra
authors.forename: Parmanand
authors.initials: P
authors.lastname: Kulhara
authors.forename: Subho
authors.initials: S
authors.lastname: Chakrabarti
authors.forename: Debasish
authors.initials: D
authors.lastname: Basu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001288:Attention; D057189:Checklist; D003693:Delirium / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008569:Memory Disorders / Q000523:psychology; D009483:Neuropsychological Tests; D009949:Orientation; D025341:Principal Component Analysis; D011567:Psychiatric Department, Hospital; D020178:Sleep Disorders, Circadian Rhythm / Q000523:psychology