Vickers Jasmine K, Wang Danny, Yefimova Maria, Armah Henrietta, Flood Kellie, Pickering Carolyn E Z
Department of Nursing Research & Scholarship, University of Alabama at Birmingham, School of Nursing, Birmingham, Alabama, USA.
Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania, USA.
Psychogeriatrics. 2025 Jan;25(1):e13226. doi: 10.1111/psyg.13226.
Delirium, a sudden and acute state of confusion, is known to be more prevalent in hospitalised older adults with dementia and is associated with lower levels of functioning after the delirium episode; yet, the literature on estimates of delirium prevalence in community-dwelling older adults with dementia is scarce. The aim of this study was to define and determine the frequency of delirium-like symptoms in two different samples of community-dwelling persons living with dementia, as reported by their family caregivers. 'Delirium-like symptoms' is a concept that specifies an occurrence of cognitive and behavioural symptoms, provoking suspicion of delirium, that represent a sudden and unusual deleterious change in a community-dwelling person living with dementia that can be identified by family caregivers and prompt healthcare seeking behaviours.
The frequencies of delirium-like symptoms were assessed from two intensive longitudinal 21-day diary studies. Caregivers reported on presence of sudden and unusual cognition and behaviours each day. Descriptive statistics were used to determine the number of caregivers who reported delirium-like symptoms.
Family caregivers (n = 50, n = 102) were predominately non-Hispanic White (75%, 61%), female (94%, 85%), and a child (60%, 59%) of the care-recipient and completed 1389 and 1739 diaries from the first and second study respectively. Caregivers reported delirium-like symptoms for 12 (24%) and 27 (27%) of care-recipients.
Other studies of delirium in community-dwelling persons living with dementia have reported similar rates. More research is needed to understand the dynamic context of delirium in community settings to improve the care provided to them by their family caregivers and clinicians in services such as home, primary, and specialty healthcare.
谵妄是一种突然出现的急性意识混乱状态，在住院的老年痴呆患者中更为普遍，并且与谵妄发作后较低的功能水平相关；然而，关于社区居住的老年痴呆患者谵妄患病率估计的文献却很匮乏。本研究的目的是定义并确定由家庭照顾者报告的，两个不同样本的社区居住痴呆患者中类似谵妄症状的发生频率。“类似谵妄症状”是一个概念，它指定了认知和行为症状的出现，引发对谵妄的怀疑，这些症状代表了社区居住的痴呆患者突然且异常的有害变化，可由家庭照顾者识别并促使其寻求医疗行为。
通过两项为期21天的密集纵向日记研究评估类似谵妄症状的发生频率。照顾者每天报告是否存在突然且异常的认知和行为。使用描述性统计来确定报告类似谵妄症状的照顾者数量。
家庭照顾者（n = 50，n = 102）主要为非西班牙裔白人（75%，61%），女性（94%，85%），且是受照顾者的子女（60%，59%），分别完成了第一项和第二项研究的1389份和1739份日记。照顾者报告有12名（24%）和27名（27%）受照顾者出现类似谵妄症状。
其他关于社区居住痴呆患者谵妄的研究报告了类似的发生率。需要更多研究来了解社区环境中谵妄的动态情况，以改善家庭照顾者和临床医生在家庭、初级和专科医疗等服务中为他们提供的护理。
