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痴呆中的谵妄

Delirium in dementia.

作者信息

Robertsson B, Blennow K, Gottfries C G, Wallin A

机构信息

Institute of Clinical Neuroscience, Department of Psychiatry and Neurochemistry, Mölndal Hospital, Sweden.

出版信息

Int J Geriatr Psychiatry. 1998 Jan;13(1):49-56. doi: 10.1002/(sici)1099-1166(199801)13:1<49::aid-gps733>3.0.co;2-4.

Abstract

Delirium is a common mental disorder in the elderly with old age being a major risk factor for delirium. Another major risk factor is dementia. The aim of the present study was to identify differences in occurrence of episodes of delirium between the most common dementia diagnoses and the possible importance of age, gender, severity and duration of dementia for the development of delirium. Included in the study were 175 consecutive patients with probable Alzheimer's disease, vascular dementia (VAD) or frontotemporal dementia (FTD) who were admitted to a neuropsychiatric diagnostic unit. There were no significant differences in sex distribution or duration of dementia between the delirious and non delirious patients. The rate of delirium was higher in late onset Alzheimer's disease (LAD) than in early onset Alzheimer's disease (EAD) and FTD. It was also higher in VAD than in EAD. The differences in occurrence of delirium between the diagnostic groups in this sample could not be explained by differences in age. It seems that delirium is more common in brain disorders such as LAD and VAD in which the damage to the brain is more widespread. In the two brain disorders that are predominantly cortical, EAD and FTD, the occurrence of delirium was comparatively low.

摘要

谵妄是老年人常见的精神障碍,老年是谵妄的主要危险因素。另一个主要危险因素是痴呆症。本研究的目的是确定最常见的痴呆症诊断之间谵妄发作发生率的差异,以及年龄、性别、痴呆症的严重程度和持续时间对谵妄发生的可能重要性。该研究纳入了175例连续入住神经精神诊断科室的可能患有阿尔茨海默病、血管性痴呆(VAD)或额颞叶痴呆(FTD)的患者。谵妄患者和非谵妄患者之间在性别分布或痴呆症持续时间上没有显著差异。晚发性阿尔茨海默病(LAD)的谵妄发生率高于早发性阿尔茨海默病(EAD)和FTD。VAD的谵妄发生率也高于EAD。该样本中诊断组之间谵妄发生率的差异无法用年龄差异来解释。似乎谵妄在诸如LAD和VAD等脑部疾病中更常见,在这些疾病中大脑损伤更为广泛。在主要为皮质性的两种脑部疾病EAD和FTD中,谵妄的发生率相对较低。

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