Adamis Dimitrios, McCarthy Geraldine, O'Mahony Edmond, Meagher David
1 Sligo Mental Health Service, Sligo, Ireland.
2 Research and Academic Institute of Athens, Athens, Greece.
J Geriatr Psychiatry Neurol. 2017 Jul;30(4):214-219. doi: 10.1177/0891988717710338. Epub 2017 May 28.
Motor disturbances in delirious patients are common, but their relationship to cognition and severity of illness has not been studied. We examined motor subtypes in an older age inpatient population, their relationship to clinical variables including delirium, and their association with 1-year mortality in a prospective study, using the Confusion Assessment Method, Acute Physiology and Chronic Health Evaluation II, Montreal Cognitive Assessment (MoCA), Barthel Index, and Delirium Rating Scale-Revised 98 (DRS-R98). Motor subtypes were evaluated using 2 items of DRS-R98. Mortality rates were investigated 1 year later. Two hundred participated (mean age 81.1 [6.5]; 50% female). Thirty-four (17%) were identified with delirium. Motor subtypes were none: 119 (59.5%), hypoactive: 37 (18.5%), hyperactive: 29 (14.5%), and mixed: 15 (7.5%). Hypoactive and mixed subtypes were significantly more frequent in delirious patients. Regression analysis showed that hypoactive subtype was significantly associated with lower MoCA. No relationship between motor subtypes and mortality was found. Motor disturbances are not unique to delirium, with hypoactivity particularly associated with impaired cognition.
谵妄患者出现运动障碍很常见，但运动障碍与认知及疾病严重程度之间的关系尚未得到研究。在一项前瞻性研究中，我们使用混乱评估法、急性生理与慢性健康状况评价II、蒙特利尔认知评估量表（MoCA）、巴氏指数和谵妄评定量表修订版98（DRS-R98），对老年住院患者的运动亚型、其与包括谵妄在内的临床变量之间的关系以及与1年死亡率的关联进行了研究。使用DRS-R98的两个项目对运动亚型进行评估。1年后调查死亡率。共有200人参与研究（平均年龄81.1岁[6.5岁]；50%为女性）。34人（17%）被诊断为谵妄。运动亚型分别为：无运动障碍：119人（59.5%），活动减退型：37人（18.5%），活动亢进型：29人（14.5%），混合型：15人（7.5%）。活动减退型和混合型在谵妄患者中更为常见。回归分析显示，活动减退型与较低的MoCA评分显著相关。未发现运动亚型与死亡率之间存在关联。运动障碍并非谵妄所特有，活动减退尤其与认知受损有关。
