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首页> 外文期刊>International psychogeriatrics >Identifying phenomenological differences and recovery of cognitive and non-cognitive symptomatology among delirium superimposed upon dementia patients (DsD) versus those without dementia (DaD) in an acute geriatric care setting
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Identifying phenomenological differences and recovery of cognitive and non-cognitive symptomatology among delirium superimposed upon dementia patients (DsD) versus those without dementia (DaD) in an acute geriatric care setting

机译：在急性老年病护理环境中，识别痴呆患者（DsD）与非痴呆患者（DaD）重叠的ir妄的现象学差异以及认知和非认知症状的恢复

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Background:Phenomenological differences between delirium superimposed on dementia (DsD) versus delirium in the absence of dementia (DaD) remain poorly understood. We aimed to identify phenomenological differences in delirium symptoms (cognitive and non-cognitive) and compare delirium recovery trajectories between DsD and DaD.Methods:We conducted a prospective observational study on individuals admitted to the Geriatric Monitoring Unit (GMU), a five-bed unit specializing in managing older adults with delirium, between December 2010 and August 2012 (n = 234; mean age 84.1 7.4). We collected data on demographics, comorbidities, severity of illness, cognitive and functional scores, and number of precipitants. Cognitive status was assessed using locally validated Chinese Mini-Mental State Examination (CMMSE) and delirium severity assessed using Delirium Rating Scale-Revised-98 (DRS-R98). Delirium disease trajectory was plotted over five days.Results:DsD patients had a longer duration of delirium with slower recovery in terms of cognition and delirium severity scores compared with DaD patients (0.33 (0.0-1.00) vs. 1.0 (0.36-2.00) increase in CMMSE per day, p < 0.001, and 1.49 +/- 1.62 vs. 2.63 +/- 2.28 decrease in DRS-R98 severity per day, p < 0.001). When cognitive and non-cognitive sub-scores of DRS-R98 were examined separately, we observed steeper recovery in both sub-scores in DaD patients. These findings remained significant after adjusting for significant baseline differences.Conclusions:Our findings of slower cognitive symptom recovery in DsD patients suggest cognitive reserve play a role in delirium syndrome development and recovery. This merits further studies to potentially aid in appropriate discharge planning and to identify potential pharmacological and non-pharmacological cognitive interventions for hospitalized older persons with delirium.
机译：背景：del妄叠加在痴呆症（DsD）与没有痴呆症（DaD）的del妄之间的现象学差异仍然知之甚少。我们旨在识别aimed妄症状（认知和非认知）的现象学差异，并比较DsD和DaD之间的del妄恢复轨迹。方法：我们对五张床位的老人监护室（GMU）进行了前瞻性观察研究。在2010年12月至2012年8月之间，专门管理with妄的老年人的部门（n = 234;平均年龄84.1 7.4）。我们收集了有关人口统计学，合并症，疾病严重程度，认知和功能评分以及沉淀物数量的数据。使用本地验证的中国小精神状态检查（CMMSE）评估认知状态，并使用Delirium Rating Scale-Revised-98（DRS-R98）评估del妄严重程度。妄疾病的轨迹历时五天。结果：与DaD病人相比，DsD病人的duration妄持续时间更长，认知和del妄严重度评分恢复较慢（0.33（0.0-1.00）vs 1.0（0.36-2.00））每天CMMSE的P <0.001，DRS-R98严重程度每天降低1.49 +/- 1.62与2.63 +/- 2.28相比，p <0.001）。当分别检查DRS-R98的认知和非认知子分数时，我们观察到DaD患者两个子分数的恢复都较陡。校正显着的基线差异后，这些发现仍然很重要。结论：我们对DsD患者认知症状恢复较慢的发现表明，认知储备在del妄综合征的发生和恢复中发挥了作用。这值得进一步研究，以潜在地帮助制定适当的出院计划，并确定住院的with妄老年人的潜在药理和非药理认知干预措施。

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