A Comparison of Neuropsychiatric and Cognitive Profiles in Delirium, Dementia, Comorbid Delirium-Dementia, and Cognitively Intact Controls

David J Meagher (1) , Maeve Leonard (1) , Sinead Donnelly (2) , Marion Conroy (2) , Jean Saunders (3) , Paula Trzepacz (4)

1 UL - University of Limerick
2 Milford Hospice
3 University of Limerck
4 Indiana University [Bloomington]

Purpose: Delirium and dementia have overlapping features that complicate differential diagnosis. Delirium symptoms overshadow dementia symptoms when they co-occur, but delirium phenomenology in comorbid cases has not been compared to both conditions alone. Methods: Consecutive adults with DSM-IV delirium, dementia, comorbid delirium-dementia, and cognitively intact controls were assessed using the Revised Delirium Rating Scale (DRS-R98) and Cognitive Test for Delirium (CTD). Results : Delirium and comorbid delirium-dementia groups had comparable DRS-R98 and CTD total scores which were greater than in dementia or control groups. On the DRS-R98, multiple non-cognitive symptoms, inattention and disorientation were more severe in delirium groups compared with dementia-alone. Patients with dementia differed from both delirium groups on the CTD test of attention. Spatial span backwards was significantly lower in all patients with cognitive impairment (delirium, comorbid delirium-dementia, dementia alone) compared to controls, whereas spatial span forwards distinguished delirium groups from dementia. Conclusions: Delirium phenomenology is similar with or without comorbid dementia. A wide range of neuropsychiatric symptoms distinguish delirium from dementia. Spatial span forward is disproportionately diminished in delirium , suggesting usefulness as a differentiating screening test.

Mots clés: COGNITION; DEMENTIA

David J Meagher, Maeve Leonard, Sinead Donnelly, Marion Conroy, Jean Saunders, et al.. A Comparison of Neuropsychiatric and Cognitive Profiles in Delirium, Dementia, Comorbid Delirium-Dementia, and Cognitively Intact Controls. Journal of Neurology, Neurosurgery and Psychiatry, 2010, 81 (8), pp.876. ⟨10.1136/jnnp.2009.200956⟩. ⟨hal-00557438⟩