Determinants of the Motoric Subtypes of Delirium in Elderly

SA, Hamza; SH, Ali; NB, El-Mashad; HS, El-sobki

doi:10.21608/ejgg.2015.5324

Determinants of the Motoric Subtypes of Delirium in Elderly

Document Type : Original Article

Authors

¹ Geriat rics and Gerontology Department , Facul ty of Medicine, Ain Shams Universi ty, Cai ro, Egypt.

² Cl inical Ppathology Depar tment , Facul ty of Medicine, Mansoura Universi ty, Dakahl ia, Egypt.

³ Geriat rics and Gerontology Department , Facul ty of Medicine, Mansoura Universi ty, Dakahl ia, Egypt.

10.21608/ejgg.2015.5324

Abstract

Background: Several studies have confi rmed the existence of three cl inical forms for del i r ium: hyperactive,
hypoactive, and mixed, based on psychomotor behavior Aim: study the association between the psychomotor activi ty among di fferent del i rium subtypes and the admission characters in del i rious elderly patients to prove a hypothesis that hypoactive del i rium car ries worse underlying admission characters.
Methods: A cross-s ec ti o nal s t udy w as c on duc te d on 4 5 ne wl y admi t te d del i ri o us el d erl y di agn os e d wi t h “C o nf us i on A s s es sm en t M et ho d ” CAM. Psychomotor activi ty was detected. Assessment of basel ine depression, function by Activi ties of dai ly l iving (ADL) , Inst rumental activi ties of dai ly l iving ( IADL), APACHE score and Erythrocyte sedimentation rate (ESR) were done.
Results: Mean age was 71.2±7.9 years ( range 60.0 –91.0). 27 (60%) of patients were females. According to
psychomotor characteristics, 19 (42.2%) of the participants were hypoactive, 13 (28.9%) were hyperactive and 13
(28.9%) were mixed. Unl ike the hyperactive groups; the hypoac tive and mixed group have signi ficantly high ESR.
There was no signi ficant association between motoric subtypes and presence of premorbid depression or
functional dependence. There was no signi ficant di fference in basel ine comorbidi ties among the three sub types.
Regarding the underlying etiology, Hypoglycemia was signi ficantly most f requent among hypoactive patients whi le
dehydration was signi ficantly most f requent among patients wi th mixed type. APACHE score and the calculated
mortal i ty score were highest in hypoactive subtype and least among hyperactive, yet , this was of no statistical
signi ficance.
Conclusions: The hypoactive form of del i rium is common among older persons. Inflammation has a role in the
pathology of hypoactive del i rium as indicated by hig h ESR. It is recommended to prompt ly recognize hypoactive
del i rium and to put a proper plan for ADL suppor t and functional rehabi l i tation.

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