Department of Older Peoples Medicine, Newcastle upon Tyne hospitals NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK; Institute of Ageing and Health, Campus of Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK.
Int J Geriatr Psychiatry. 2014 Feb;29(2):178-81. doi: 10.1002/gps.3986. Epub 2013 May 31.
Delirium is common and is associated with an increased risk of dementia. However, it is not clear whether delirium confers increased risk of any particular type of dementia. We performed a retrospective study of Alzheimer's disease (AD) and Dementia with Lewy bodies (DLB) to ascertain whether a suspected episode of preceding delirium was more common prior to diagnosis in either type of dementia.
The study was carried out in a tertiary referral unit for the diagnosis of dementia. Clinic letters from the first presentation to the unit of 85 cases with DLB and 95 cases of AD were reviewed for documentation of any previous episodes of suspected delirium.
In this study, 25% of DLB cases had at least one reported episode of suspected delirium as compared to 7% of AD cases (p = 0.001). For the DLB cases who had a prior suspected delirium, 23% had more than one episode compared with 14% of the AD group. The median time between most recent suspected episode of delirium and diagnosis of dementia in both groups was less than a year
A greater proportion of those presenting and diagnosed with DLB had a documentation of a suspected delirium than those diagnosed with AD. Delirium may lead to a higher risk of DLB as opposed to other forms of dementia, or delirium may, at least in some cases, represent the early stages of DLB. These data suggest that a diagnosis of DLB should be specifically considered in those presenting with a delirium.
谵妄很常见，并且与痴呆风险增加有关。但是，目前尚不清楚谵妄是否会增加任何特定类型痴呆的风险。我们对阿尔茨海默病（AD）和路易体痴呆（DLB）进行了回顾性研究，以确定在这两种痴呆症中，在诊断之前是否有更多的疑似谵妄发作。
这项研究是在一家专门诊断痴呆症的三级转诊单位进行的。对首次就诊于该单位的 85 例 DLB 患者和 95 例 AD 患者的临床病历进行了回顾，以记录任何先前疑似谵妄发作的情况。
在这项研究中，25%的 DLB 病例至少有一次疑似谵妄发作，而 AD 病例为 7%（p=0.001）。对于有先前疑似谵妄的 DLB 病例，23%的患者有多次发作，而 AD 组的这一比例为 14%。两组中，最近一次疑似谵妄发作与痴呆诊断之间的中位数时间均不到一年。
与 AD 患者相比，更多的 DLB 患者有疑似谵妄的记录。谵妄可能会导致 DLB 的风险增加，而不是其他形式的痴呆，或者至少在某些情况下，谵妄可能代表 DLB 的早期阶段。这些数据表明，对于出现谵妄的患者，应特别考虑 DLB 的诊断。
