Contribution of Different Brain Disorders and Multimorbidity to Delirium Superimposed Dementia (DSD)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Subjects
2.2. Measures
2.3. Statistical Analysis
3. Results
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Other Diagnoses | Dementia Alone | Delirium Alone | Delirium Super- Imposed Dementia | Statistics ANOVA | |
---|---|---|---|---|---|
n | 197 | 105 | 46 | 218 | |
Age (range 66–101) | 76.6 ± 7.5 | 80.1 ± 7.2 | 77.5 ± 8.0 | 76.6 ± 7.5 | F = 20.8 df 3 p < 0.001 |
Gender [male] | 31.5% | 30.5% | 34.8% | 33.9% | Chi2 0.61 df 3 p = 0.895 |
CDR (max. 3) | 0.1 ± 0.2 | 1.6 ± 0.6 | 0.2 ± 0.3 | 2.2 ± 0.8 | F = 508.8 df 3 p < 0.001 |
CAM-S (max. 7) | 2.2 ± 1.6 | 3.4 ± 1.3 | 5.5 ± 1.4 | 5.9 ± 1.7 | F = 211.8 df 3 p < 0.001 |
DRS-98 (max. 16) | 5.2 ± 2.4 | 7.8 ± 2.0 | 11.1 ± 2.4 | 11.4 ± 2.5 | F = 250.7 df 3 p < 0.001 |
CIRS 13 (Max. 52) | 12.7 ± 3.5 | 13.3 ± 3.8 | 13.4 ± 4.0 | 12.9 ± 3.8 | F = 36.9 df 3 p = 0.890 |
cCT findings | |||||
Infarcts | 18 (22.0%) | 18 (17.1%) | 7 (15.2%) | 39 (17.9%) | Chi2 7.21 df 3 p = 0.066 |
WMH | 104 (52.8%) | 68 (64,8%) | 29 (63.0%) | 123 (56.4%) | Chi2 4.71 df 3 p = 0.194 |
Dementia Alone | Delirium Superimposed Dementia | Statistics | |
---|---|---|---|
n | 105 | 218 | |
Age (range 66–101) | 80.1 ± 7.2 | 76.6 ± 7.5 | ANOVA F = 5.97 df 1 p = 0.015 |
Gender [male] | 30.2 | 33.9% | Odds ratio 0.85 (95% CI 0.51…1.41) |
CDR (max. 3) | 1.6 ± 0.6 | 2.2 ± 0.8 | ANOVA F = 44.9 df = 1 p < 0.001 |
Multimorbidity | |||
Number of ICD-10 diagnoses | 10.5 ± 3.3 | 11.1 ± 3.7 | ANOVA F= 1.93 df = 1 p = 0.165 |
CIRS-13 (max. 52) | 13.3 ± 3.8 | 12.9 ± 3.8 | ANOVA F = 0.81 df = 1 p = 0.370 |
MNA- SF (max. 14) | 7.3 ± 1.6 | 6.5 ± 1.7 | ANOVA F = 18.3 df = 1 p < 0.001 |
Disability | |||
Visual impairment | 8 (7.6%) | 19 (8.7%) | Odds ratio 1.16 (95% CI 0.49…2.74) |
Hearing loss | 16 (15.2%) | 46 (21.1%) | Odds ratio 1.49 (95% CI 0.80…2.78) |
Restricted mobility | 30 (28.6%) | 58 (26.6%) | Odds ratio 0.91 (95% CI 0.54…1.52) |
cCT findings | |||
Infarcts | 18 (17.1%) | 39 (17.9%) | Odds ratio 1.05 (95% CI 0.57…1.95) |
WMH | 68 (64.8%) | 123 (56.4%) | Odds ratio 0.73 (95% CI 0.46…1.19) |
cCT-Finding | Atrophy Only | Infarction | WMH | Statistics |
---|---|---|---|---|
n | 56 | 39 | 123 | |
Age [years] | 79.9 ± 6.6 | 82.8 ± 7.4 | 83.0 ± 7.0 | F = 4.00 df 2 p = 0.020 |
Gender [% male] | 41.1% | 38.5% | 29.3% | Chi2 2.82 df 2 p = 0.244 |
CDR (max. 3) | 2.3 ± 0.7 | 2.3 ± 0.7 | 2.1 ± 0.8 | F = 3.25 df 2 p = 0.040 |
CAM-S (max. 7) | 6.0 ± 1.8 | 5.9 ± 1.5 | 5.9 ± 1.7 | F = 0.04 df 2 p= 0.961 |
DRS-98 (max. 16) | 11.4 ± 2.7 | 12.1 ± 2.5 | 11.2 ± 2.3 | F = 1.96 df 2 p = 0.143 |
Multimorbidity | ||||
Number of ICD-10 diagnoses | 10.7 ± 4.0 | 11.6 ± 3.3 | 11.2 ± 3.7 | F = 0.83 df 2 p = 0.438 |
CIRS-13 (max. 52) | 12.8 ± 3.7 | 14.1 ± 3.5 | 12.5 ± 4.0 | F = 2,78 df 2 p = 0.064 |
MNA-SF (max. 14) | 6.4 ± 1.5 | 6.6 ± 1.7 | 6.5 ± 1.7 | F = 0.19 df 2 p = 0.829 |
Disability | ||||
Visual impairment | 2 (3.6%) | 8 (20.5%) | 9 (7.3%) | Chi2 8.99 df 2 p = 0.011 |
Hearing loss | 8 (14.3%) | 9 (23.1%) | 29 (23.6%) | Chi2 2.11 df 2 p = 0.349 |
Restricted mobility | 19 (33.9%) | 14 (35.9%) | 25 (20.3%) | Chi2 5.75 df 2 p = 0.057 |
Dementia Alone | Delirium Superimposed Dementia | Statistics | |
---|---|---|---|
Elevated Hba1c (>6.5%) | 48 (45.7%) | 73 (33.5%) | Odds ratio 0.60 (95% CI 0.37 …0.96) |
Leukocytosis (>9000/µL) | 15 (14.3%) | 37 (17.0%) | Odds ratio 1,23 (95% CI 0.64 …2.35) |
Anemia (Hb females < 12 g/L, males < 14 g/L) | 60 (57.1%) | 121 (55.5%) | Odds ratio 0.94 (95% CI 0.59 …1.50) |
Hematocrit (%) | 15 (14.3%) | 41 (18.8%) | Odds ratio 1.39 (95% CI 0.73 …2.65) |
Hyponatremia (<135 mmol/L) | 7 (6.7%) | 17 (7.8%) | Odds ratio 1.18 (95% CI 0.48 …2.95) |
Elevated creatinine (>90 mg/L) | 47 (44.8%) | 92 (42.2%) | Odds ratio 0.90 (95% CI 0.56 …1.44) |
TSH (<0.25 µU/mL) | 9 (8.6%) | 20 (9.2%) | Odds ratio 1.08 (95% CI 0.47 …2.46) |
Current Infection | 29 (27.6%) | 86 (39.4%) | Odds ratio 1.71 (95% CI 1.03 …2.83) |
Dehydration | 22 (21.0%) | 57 (26.1%) | Odds ratio 1.33 (95% CI 0.76 …2.34) |
Medication | |||
Psychotropic drugs | 1.7 ± 1.1 | 1.9 ± 1.0 | ANOVA F 2.08 df 2 p = 0.150 |
Other medication | 4.8 ± 2.9 | 4.5 ± 2.6 | ANOVA F 0.99 df 2 p = 0.320 |
cCT Finding | No Or Atrophy | Infarction | WMH | Statistics |
---|---|---|---|---|
Elevated Hba1c (>6.5%) | 19 (33.9%) | 10 (25.6%) | 44 (35.8%) | Chi2 1.37 df 2 p = 0.504 |
Leukocytosis (>9000/µL) | 6 (10.7%) | 6 (15.4%) | 25 (20.3%) | Chi2 2.61 df 2 p = 0.272 |
Anemia (Hb females < 12 g/ L, males < 14 g/L) | 36 (64.3%) | 23 (59.0%) | 62 (50.4%) | Chi2 3.23 df 2 p = 0.199 |
Hematocrit (%) | 7 (12.5%) | 8 (20.5%) | 26 (21.1%) | Chi2 1.97 df 2 p = 0.373 |
Hyponatremia (>135 mmol/L) | 3 (5.4%) | 4 (10.3%) | 10 (8.1%) | Chi2 0.81 df 2 p = 0.667 |
Elevated creatinine (>90 mg/L) | 21 (37.5%) | 14 (35.9%) | 57 (46.3%) | Chi2 2.00 df 2 p = 0.365 |
TSH (<0.25 µU/mL) | 5 (8.9%) | 1 (2.6%) | 14 (11.4%) | Chi2 2.77 df 2 p = 0.250 |
Current infection | 18 (32.1%) | 18 (46.2%) | 50 (40.7%) | Chi2 2.00 df 2 p = 0.357 |
Dehydration | 13 (23.2%) | 9 (15.8%) | 35 (28.5%) | Chi2 0.78 df 2 p = 0.677 |
Restricted mobility | 19 (33.9%) | 14 (35.9%) | 25 (20.3%) | Chi2 5.75 df 2 p = 0.057 |
Medication | ||||
Psychotropic drugs (range 0–4) | 2.3 ± 1.0 | 1.7 ± 1.0 | 1.8 ± 1.0 | ANOVA F = 6.10 df 2 p = 0.003 |
Other medication (range 0–15) | 3.5 ± 2.1 | 4.5 ± 2.8 | 5.0 ± 2.7 | ANOVA F = 6.10 df 2 p = 0.003 |
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Wetterling, T.; Junghanns, K. Contribution of Different Brain Disorders and Multimorbidity to Delirium Superimposed Dementia (DSD). Geriatrics 2023, 8, 64. https://doi.org/10.3390/geriatrics8030064
Wetterling T, Junghanns K. Contribution of Different Brain Disorders and Multimorbidity to Delirium Superimposed Dementia (DSD). Geriatrics. 2023; 8(3):64. https://doi.org/10.3390/geriatrics8030064
Chicago/Turabian StyleWetterling, Tilman, and Klaus Junghanns. 2023. "Contribution of Different Brain Disorders and Multimorbidity to Delirium Superimposed Dementia (DSD)" Geriatrics 8, no. 3: 64. https://doi.org/10.3390/geriatrics8030064