Yaria J O, Ogunjimi L O, Adebiyi A O, Olakehinde O O, Makanjuola A I, Paddick S M, Ogunniyi A
Department of Medicine, College of Medicine, University of Ibadan, Ibadan. Nigeria.
West Afr J Med. 2019 May-Aug;36(2):183-188.
There is paucity of information on delirium in sub-Saharan Africa (SSA) particularly in the older persons (>60 years of age), leaving questions about the burden of the disease in an environment with lower health care standards. In this article, we set out to determine the frequency, precipitants and symptomatology of delirium in elderly patients admitted into medical wards in a teaching hospital in South-West Nigeria.
This was a descriptive study involving a pre-planned sample of one hundred and fifty patients aged 60 years and over, assessed for cognitive impairment and delirium using the previously validated IDEA cognitive screen, and the Confusion Assessment Method (CAM) respectively. Diagnosis of delirium was made using the CAM and DSM-IV criteria.
Delirium was diagnosed in 32 patients giving a frequency of 21.3% (95%CI: 14.7-30.0%). Patients with delirium were significantly older (p<0.05). A quarter of the patients had dementia. Hypertension was a notable co-morbid condition. All the patients had altered sleep wake cycle, inattention, disorientation, and altered consciousness. Neurological diseases were the most common precipitant. There was a good agreement between the DSM-IV and CAM diagnoses.
Delirium is common in hospitalised elderly patients particularly those with neurological diseases. Co-morbidities like hypertension, dementia, and depression should be looked for in delirious elderly patients.
撒哈拉以南非洲地区（SSA）关于谵妄的信息匮乏，尤其是在老年人（>60岁）中，这使得在医疗保健标准较低的环境中，关于该疾病负担的问题仍未得到解答。在本文中，我们着手确定尼日利亚西南部一家教学医院内科病房收治的老年患者中谵妄的发生率、诱发因素及症状表现。
这是一项描述性研究，涉及预先计划抽取的150名60岁及以上的患者样本，分别使用先前验证过的IDEA认知筛查工具和谵妄评估方法（CAM）对认知障碍和谵妄进行评估。谵妄的诊断采用CAM和《精神疾病诊断与统计手册》第四版（DSM-IV）标准。
32名患者被诊断为谵妄，发生率为21.3%（95%置信区间：14.7 - 30.0%）。谵妄患者的年龄显著更大（p<0.05）。四分之一的患者患有痴呆症。高血压是一种显著的合并症。所有患者均有睡眠 - 觉醒周期改变、注意力不集中、定向障碍和意识改变。神经系统疾病是最常见的诱发因素。DSM-IV和CAM诊断之间有良好的一致性。
谵妄在住院老年患者中很常见，尤其是患有神经系统疾病的患者。对于谵妄的老年患者，应查找高血压、痴呆症和抑郁症等合并症。
