The Diagnosis of Delirium Superimposed on Dementia: An Emerging Challenge
Identifieur interne : 000736 ( Pmc/Corpus ); précédent : 000735; suivant : 000737The Diagnosis of Delirium Superimposed on Dementia: An Emerging Challenge
Auteurs : Alessandro Morandi ; Daniel Davis ; Giuseppe Bellelli ; Rakesh C. Arora ; Gideon A. Caplan ; Barbara Kamholz ; Ann Kolanowski ; Donna Marie Fick ; Stefan Kreisel ; Alasdair Maclullich ; Mrcp Uk ; David Meagher ; Karen Neufeld ; Pratik P. Pandharipande ; Sarah Richardson ; Arjen J. C. Slooter ; John P. Taylor ; Christine Thomas ; Zoë Tieges ; Andrew Teodorczuk ; Philippe Voyer ; James L. RudolphSource :
- Journal of the American Medical Directors Association [ 1525-8610 ] ; 2016.
Abstract
Delirium occurring in patients with dementia is referred to as delirium superimposed on dementia (DSD). People who are older with dementia and who are institutionalized are at increased risk of developing delirium when hospitalized. In addition, their prior cognitive impairment makes detecting their delirium a challenge. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and the International Statistical Classification of Diseases and Related Health Problems, 10th Revision are considered the standard reference for the diagnosis of delirium and include criteria of impairments in cognitive processes such as attention, additional cognitive disturbances, or altered level of arousal. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and the International Statistical Classification of Diseases and Related Health Problems, 10th Revision does not provide guidance regarding specific tests for assessment of the cognitive process impaired in delirium. Importantly, the assessment or inclusion of preexisting cognitive impairment is also not addressed by these standards. The challenge of DSD gets more complex as types of dementia, particularly dementia with Lewy bodies, which has features of both delirium and dementia, are considered. The objective of this article is to critically review key elements for the diagnosis of DSD, including the challenge of neuropsychological assessment in patients with dementia and the influence of particular tests used to diagnose DSD. To address the challenges of DSD diagnosis, we present a framework for guiding the focus of future research efforts to develop a reliable reference standard to diagnose DSD. A key feature of a reliable reference standard will improve the ability to clinically diagnose DSD in facility-based patients and research studies.
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DOI: 10.1016/j.jamda.2016.07.014
PubMed: 27650668
PubMed Central: 5373084
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The Diagnosis of Delirium Superimposed on Dementia: An Emerging Challenge</title><author><name sortKey="Morandi, Alessandro" sort="Morandi, Alessandro" uniqKey="Morandi A" first="Alessandro" last="Morandi">Alessandro Morandi</name><affiliation><nlm:aff id="A1">Department of Rehabilitation and Aged Care of the Fondazione Camplani, Ancelle Hospital, Cremona, Italy</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Geriatric Research Group, Brescia, Italy</nlm:aff></affiliation></author><author><name sortKey="Davis, Daniel" sort="Davis, Daniel" uniqKey="Davis D" first="Daniel" last="Davis">Daniel Davis</name><affiliation><nlm:aff id="A3">University College London, London, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Bellelli, Giuseppe" sort="Bellelli, Giuseppe" uniqKey="Bellelli G" first="Giuseppe" last="Bellelli">Giuseppe Bellelli</name><affiliation><nlm:aff id="A2">Geriatric Research Group, Brescia, Italy</nlm:aff></affiliation><affiliation><nlm:aff id="A4">School of Medicine and Surgery, University of Milano-Bicocca, Milan, and Geriatric Unit, San Gerardo hospital, Monza, Italy</nlm:aff></affiliation></author><author><name sortKey="Arora, Rakesh C" sort="Arora, Rakesh C" uniqKey="Arora R" first="Rakesh C." last="Arora">Rakesh C. Arora</name><affiliation><nlm:aff id="A5">Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba Canada; Cardiac Sciences Program, St. Boniface Hospital, Winnipeg, Manitoba, Canada</nlm:aff></affiliation></author><author><name sortKey="Caplan, Gideon A" sort="Caplan, Gideon A" uniqKey="Caplan G" first="Gideon A." last="Caplan">Gideon A. Caplan</name><affiliation><nlm:aff id="A6">Department of Geriatric Medicine, Prince of Wales Hospital, Sydney, Australia Prince of Wales Clinical School, University of New South Wales, Sydney, Australia</nlm:aff></affiliation></author><author><name sortKey="Kamholz, Barbara" sort="Kamholz, Barbara" uniqKey="Kamholz B" first="Barbara" last="Kamholz">Barbara Kamholz</name><affiliation><nlm:aff id="A7">Department of Psychiatry, University of California at San Francisco, San Francisco, CA</nlm:aff></affiliation></author><author><name sortKey="Kolanowski, Ann" sort="Kolanowski, Ann" uniqKey="Kolanowski A" first="Ann" last="Kolanowski">Ann Kolanowski</name><affiliation><nlm:aff id="A8">College of Nursing and College of Medicine, The Pennsylvania State University, University Park, PA</nlm:aff></affiliation></author><author><name sortKey="Fick, Donna Marie" sort="Fick, Donna Marie" uniqKey="Fick D" first="Donna Marie" last="Fick">Donna Marie Fick</name><affiliation><nlm:aff id="A9">Penn State College of Nursing, The Pennsylvania State University, University Park, PA</nlm:aff></affiliation></author><author><name sortKey="Kreisel, Stefan" sort="Kreisel, Stefan" uniqKey="Kreisel S" first="Stefan" last="Kreisel">Stefan Kreisel</name><affiliation><nlm:aff id="A10">Department of Psychiatry and Psychotherapy, Bethel EvangelischesKrankenhaus, Bielefeld, Germany</nlm:aff></affiliation></author><author><name sortKey="Maclullich, Alasdair" sort="Maclullich, Alasdair" uniqKey="Maclullich A" first="Alasdair" last="Maclullich">Alasdair Maclullich</name></author><author><name sortKey=" Uk, Mrcp" sort=" Uk, Mrcp" uniqKey=" Uk M" first="Mrcp" last=" Uk">Mrcp Uk</name><affiliation><nlm:aff id="A11">Edinburgh Delirium Research Group, University of Edinburgh, Edinburgh, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Meagher, David" sort="Meagher, David" uniqKey="Meagher D" first="David" last="Meagher">David Meagher</name><affiliation><nlm:aff id="A12">Graduate-entry Medical School, Cognitive Impairment Research Group, Center for Interventions in Infection, Inflammation and Immunity, Graduate Entry Medical School, University of Limerick, Limerick, Ireland</nlm:aff></affiliation></author><author><name sortKey="Neufeld, Karen" sort="Neufeld, Karen" uniqKey="Neufeld K" first="Karen" last="Neufeld">Karen Neufeld</name><affiliation><nlm:aff id="A13">Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD</nlm:aff></affiliation></author><author><name sortKey="Pandharipande, Pratik P" sort="Pandharipande, Pratik P" uniqKey="Pandharipande P" first="Pratik P." last="Pandharipande">Pratik P. Pandharipande</name><affiliation><nlm:aff id="A14">Department of Anesthesiology, Division of Critical Care, Vanderbilt University School of Medicine, and the Anesthesia Service, Department of Veterans Affairs, Tennessee Valley Healthcare System</nlm:aff></affiliation></author><author><name sortKey="Richardson, Sarah" sort="Richardson, Sarah" uniqKey="Richardson S" first="Sarah" last="Richardson">Sarah Richardson</name><affiliation><nlm:aff id="A15">Institute of Neuroscience, Newcastle University, Newcastle-upon-Tyne, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Slooter, Arjen J C" sort="Slooter, Arjen J C" uniqKey="Slooter A" first="Arjen J. C." last="Slooter">Arjen J. C. Slooter</name><affiliation><nlm:aff id="A16">Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht, The Netherlands</nlm:aff></affiliation></author><author><name sortKey="Taylor, John P" sort="Taylor, John P" uniqKey="Taylor J" first="John P." last="Taylor">John P. Taylor</name><affiliation><nlm:aff id="A17">Campus for Ageing and Vitality, Newcastle University, Newcastle-upon-Tyne, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Thomas, Christine" sort="Thomas, Christine" uniqKey="Thomas C" first="Christine" last="Thomas">Christine Thomas</name><affiliation><nlm:aff id="A18">Department of Psychiatry and Psychotherapy of the Aged, Center of Mental Health, Klinikum Stuttgart, Germany</nlm:aff></affiliation></author><author><name sortKey="Tieges, Zoe" sort="Tieges, Zoe" uniqKey="Tieges Z" first="Zoë" last="Tieges">Zoë Tieges</name><affiliation><nlm:aff id="A11">Edinburgh Delirium Research Group, University of Edinburgh, Edinburgh, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Teodorczuk, Andrew" sort="Teodorczuk, Andrew" uniqKey="Teodorczuk A" first="Andrew" last="Teodorczuk">Andrew Teodorczuk</name><affiliation><nlm:aff id="A19">School of Medicine and Health Institute for the Development of Education and Scholarship (HEALTH IDEAS), Griffith University, Queensland, Australia</nlm:aff></affiliation></author><author><name sortKey="Voyer, Philippe" sort="Voyer, Philippe" uniqKey="Voyer P" first="Philippe" last="Voyer">Philippe Voyer</name><affiliation><nlm:aff id="A20">Laval University, Quebec City, Canada Center for Excellence in Aging-Research Unit, Quebec City, Canada</nlm:aff></affiliation></author><author><name sortKey="Rudolph, James L" sort="Rudolph, James L" uniqKey="Rudolph J" first="James L." last="Rudolph">James L. Rudolph</name><affiliation><nlm:aff id="A21">Center of Innovation in Long-Term Services and Supports, Providence VA Medical Center, Providence, RI</nlm:aff></affiliation><affiliation><nlm:aff id="A22">Warren Alpert School of Medicine at Brown University, Providence, RI</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27650668</idno><idno type="pmc">5373084</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5373084</idno><idno type="RBID">PMC:5373084</idno><idno type="doi">10.1016/j.jamda.2016.07.014</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000736</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000736</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The Diagnosis of Delirium Superimposed on Dementia: An Emerging Challenge</title><author><name sortKey="Morandi, Alessandro" sort="Morandi, Alessandro" uniqKey="Morandi A" first="Alessandro" last="Morandi">Alessandro Morandi</name><affiliation><nlm:aff id="A1">Department of Rehabilitation and Aged Care of the Fondazione Camplani, Ancelle Hospital, Cremona, Italy</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Geriatric Research Group, Brescia, Italy</nlm:aff></affiliation></author><author><name sortKey="Davis, Daniel" sort="Davis, Daniel" uniqKey="Davis D" first="Daniel" last="Davis">Daniel Davis</name><affiliation><nlm:aff id="A3">University College London, London, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Bellelli, Giuseppe" sort="Bellelli, Giuseppe" uniqKey="Bellelli G" first="Giuseppe" last="Bellelli">Giuseppe Bellelli</name><affiliation><nlm:aff id="A2">Geriatric Research Group, Brescia, Italy</nlm:aff></affiliation><affiliation><nlm:aff id="A4">School of Medicine and Surgery, University of Milano-Bicocca, Milan, and Geriatric Unit, San Gerardo hospital, Monza, Italy</nlm:aff></affiliation></author><author><name sortKey="Arora, Rakesh C" sort="Arora, Rakesh C" uniqKey="Arora R" first="Rakesh C." last="Arora">Rakesh C. Arora</name><affiliation><nlm:aff id="A5">Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba Canada; Cardiac Sciences Program, St. Boniface Hospital, Winnipeg, Manitoba, Canada</nlm:aff></affiliation></author><author><name sortKey="Caplan, Gideon A" sort="Caplan, Gideon A" uniqKey="Caplan G" first="Gideon A." last="Caplan">Gideon A. Caplan</name><affiliation><nlm:aff id="A6">Department of Geriatric Medicine, Prince of Wales Hospital, Sydney, Australia Prince of Wales Clinical School, University of New South Wales, Sydney, Australia</nlm:aff></affiliation></author><author><name sortKey="Kamholz, Barbara" sort="Kamholz, Barbara" uniqKey="Kamholz B" first="Barbara" last="Kamholz">Barbara Kamholz</name><affiliation><nlm:aff id="A7">Department of Psychiatry, University of California at San Francisco, San Francisco, CA</nlm:aff></affiliation></author><author><name sortKey="Kolanowski, Ann" sort="Kolanowski, Ann" uniqKey="Kolanowski A" first="Ann" last="Kolanowski">Ann Kolanowski</name><affiliation><nlm:aff id="A8">College of Nursing and College of Medicine, The Pennsylvania State University, University Park, PA</nlm:aff></affiliation></author><author><name sortKey="Fick, Donna Marie" sort="Fick, Donna Marie" uniqKey="Fick D" first="Donna Marie" last="Fick">Donna Marie Fick</name><affiliation><nlm:aff id="A9">Penn State College of Nursing, The Pennsylvania State University, University Park, PA</nlm:aff></affiliation></author><author><name sortKey="Kreisel, Stefan" sort="Kreisel, Stefan" uniqKey="Kreisel S" first="Stefan" last="Kreisel">Stefan Kreisel</name><affiliation><nlm:aff id="A10">Department of Psychiatry and Psychotherapy, Bethel EvangelischesKrankenhaus, Bielefeld, Germany</nlm:aff></affiliation></author><author><name sortKey="Maclullich, Alasdair" sort="Maclullich, Alasdair" uniqKey="Maclullich A" first="Alasdair" last="Maclullich">Alasdair Maclullich</name></author><author><name sortKey=" Uk, Mrcp" sort=" Uk, Mrcp" uniqKey=" Uk M" first="Mrcp" last=" Uk">Mrcp Uk</name><affiliation><nlm:aff id="A11">Edinburgh Delirium Research Group, University of Edinburgh, Edinburgh, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Meagher, David" sort="Meagher, David" uniqKey="Meagher D" first="David" last="Meagher">David Meagher</name><affiliation><nlm:aff id="A12">Graduate-entry Medical School, Cognitive Impairment Research Group, Center for Interventions in Infection, Inflammation and Immunity, Graduate Entry Medical School, University of Limerick, Limerick, Ireland</nlm:aff></affiliation></author><author><name sortKey="Neufeld, Karen" sort="Neufeld, Karen" uniqKey="Neufeld K" first="Karen" last="Neufeld">Karen Neufeld</name><affiliation><nlm:aff id="A13">Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD</nlm:aff></affiliation></author><author><name sortKey="Pandharipande, Pratik P" sort="Pandharipande, Pratik P" uniqKey="Pandharipande P" first="Pratik P." last="Pandharipande">Pratik P. Pandharipande</name><affiliation><nlm:aff id="A14">Department of Anesthesiology, Division of Critical Care, Vanderbilt University School of Medicine, and the Anesthesia Service, Department of Veterans Affairs, Tennessee Valley Healthcare System</nlm:aff></affiliation></author><author><name sortKey="Richardson, Sarah" sort="Richardson, Sarah" uniqKey="Richardson S" first="Sarah" last="Richardson">Sarah Richardson</name><affiliation><nlm:aff id="A15">Institute of Neuroscience, Newcastle University, Newcastle-upon-Tyne, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Slooter, Arjen J C" sort="Slooter, Arjen J C" uniqKey="Slooter A" first="Arjen J. C." last="Slooter">Arjen J. C. Slooter</name><affiliation><nlm:aff id="A16">Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht, The Netherlands</nlm:aff></affiliation></author><author><name sortKey="Taylor, John P" sort="Taylor, John P" uniqKey="Taylor J" first="John P." last="Taylor">John P. Taylor</name><affiliation><nlm:aff id="A17">Campus for Ageing and Vitality, Newcastle University, Newcastle-upon-Tyne, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Thomas, Christine" sort="Thomas, Christine" uniqKey="Thomas C" first="Christine" last="Thomas">Christine Thomas</name><affiliation><nlm:aff id="A18">Department of Psychiatry and Psychotherapy of the Aged, Center of Mental Health, Klinikum Stuttgart, Germany</nlm:aff></affiliation></author><author><name sortKey="Tieges, Zoe" sort="Tieges, Zoe" uniqKey="Tieges Z" first="Zoë" last="Tieges">Zoë Tieges</name><affiliation><nlm:aff id="A11">Edinburgh Delirium Research Group, University of Edinburgh, Edinburgh, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Teodorczuk, Andrew" sort="Teodorczuk, Andrew" uniqKey="Teodorczuk A" first="Andrew" last="Teodorczuk">Andrew Teodorczuk</name><affiliation><nlm:aff id="A19">School of Medicine and Health Institute for the Development of Education and Scholarship (HEALTH IDEAS), Griffith University, Queensland, Australia</nlm:aff></affiliation></author><author><name sortKey="Voyer, Philippe" sort="Voyer, Philippe" uniqKey="Voyer P" first="Philippe" last="Voyer">Philippe Voyer</name><affiliation><nlm:aff id="A20">Laval University, Quebec City, Canada Center for Excellence in Aging-Research Unit, Quebec City, Canada</nlm:aff></affiliation></author><author><name sortKey="Rudolph, James L" sort="Rudolph, James L" uniqKey="Rudolph J" first="James L." last="Rudolph">James L. Rudolph</name><affiliation><nlm:aff id="A21">Center of Innovation in Long-Term Services and Supports, Providence VA Medical Center, Providence, RI</nlm:aff></affiliation><affiliation><nlm:aff id="A22">Warren Alpert School of Medicine at Brown University, Providence, RI</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of the American Medical Directors Association</title><idno type="ISSN">1525-8610</idno><idno type="eISSN">1538-9375</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p id="P1">Delirium occurring in patients with dementia is referred to as delirium superimposed on dementia (DSD). People who are older with dementia and who are institutionalized are at increased risk of developing delirium when hospitalized. In addition, their prior cognitive impairment makes detecting their delirium a challenge. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and the International Statistical Classification of Diseases and Related Health Problems, 10th Revision are considered the standard reference for the diagnosis of delirium and include criteria of impairments in cognitive processes such as attention, additional cognitive disturbances, or altered level of arousal. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and the International Statistical Classification of Diseases and Related Health Problems, 10th Revision does not provide guidance regarding specific tests for assessment of the cognitive process impaired in delirium. Importantly, the assessment or inclusion of preexisting cognitive impairment is also not addressed by these standards. The challenge of DSD gets more complex as types of dementia, particularly dementia with Lewy bodies, which has features of both delirium and dementia, are considered. The objective of this article is to critically review key elements for the diagnosis of DSD, including the challenge of neuropsychological assessment in patients with dementia and the influence of particular tests used to diagnose DSD. To address the challenges of DSD diagnosis, we present a framework for guiding the focus of future research efforts to develop a reliable reference standard to diagnose DSD. A key feature of a reliable reference standard will improve the ability to clinically diagnose DSD in facility-based patients and research studies.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">100893243</journal-id><journal-id journal-id-type="pubmed-jr-id">30377</journal-id><journal-id journal-id-type="nlm-ta">J Am Med Dir Assoc</journal-id><journal-id journal-id-type="iso-abbrev">J Am Med Dir Assoc</journal-id><journal-title-group><journal-title>Journal of the American Medical Directors Association</journal-title></journal-title-group><issn pub-type="ppub">1525-8610</issn><issn pub-type="epub">1538-9375</issn></journal-meta><article-meta><article-id pub-id-type="pmid">27650668</article-id><article-id pub-id-type="pmc">5373084</article-id><article-id pub-id-type="doi">10.1016/j.jamda.2016.07.014</article-id><article-id pub-id-type="manuscript">NIHMS852074</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>The Diagnosis of Delirium Superimposed on Dementia: An Emerging Challenge</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Morandi</surname><given-names>Alessandro</given-names></name><degrees>MD, MPH</degrees><xref ref-type="aff" rid="A1">a</xref><xref ref-type="aff" rid="A2">b</xref><xref rid="FN1" ref-type="author-notes">*</xref></contrib><contrib contrib-type="author"><name><surname>Davis</surname><given-names>Daniel</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A3">c</xref></contrib><contrib contrib-type="author"><name><surname>Bellelli</surname><given-names>Giuseppe</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A2">b</xref><xref ref-type="aff" rid="A4">d</xref></contrib><contrib contrib-type="author"><name><surname>Arora</surname><given-names>Rakesh C.</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A5">e</xref></contrib><contrib contrib-type="author"><name><surname>Caplan</surname><given-names>Gideon A.</given-names></name><degrees>MBBS, MD, FRACP</degrees><xref ref-type="aff" rid="A6">f</xref></contrib><contrib contrib-type="author"><name><surname>Kamholz</surname><given-names>Barbara</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A7">g</xref></contrib><contrib contrib-type="author"><name><surname>Kolanowski</surname><given-names>Ann</given-names></name><degrees>PhD, RN, FAAN</degrees><xref ref-type="aff" rid="A8">h</xref></contrib><contrib contrib-type="author"><name><surname>Fick</surname><given-names>Donna Marie</given-names></name><degrees>RN, PhD</degrees><xref ref-type="aff" rid="A9">i</xref></contrib><contrib contrib-type="author"><name><surname>Kreisel</surname><given-names>Stefan</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A10">j</xref></contrib><contrib contrib-type="author"><name><surname>MacLullich</surname><given-names>Alasdair</given-names></name></contrib><contrib contrib-type="author"><name><surname>(UK)</surname><given-names>MRCP</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A11">k</xref></contrib><contrib contrib-type="author"><name><surname>Meagher</surname><given-names>David</given-names></name><degrees>MD, MRCP</degrees><xref ref-type="aff" rid="A12">l</xref></contrib><contrib contrib-type="author"><name><surname>Neufeld</surname><given-names>Karen</given-names></name><degrees>MD, MPH</degrees><xref ref-type="aff" rid="A13">m</xref></contrib><contrib contrib-type="author"><name><surname>Pandharipande</surname><given-names>Pratik P.</given-names></name><degrees>MD, MSCI</degrees><xref ref-type="aff" rid="A14">n</xref></contrib><contrib contrib-type="author"><name><surname>Richardson</surname><given-names>Sarah</given-names></name><degrees>MBBS, MRCP</degrees><xref ref-type="aff" rid="A15">o</xref></contrib><contrib contrib-type="author"><name><surname>Slooter</surname><given-names>Arjen J.C.</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A16">p</xref></contrib><contrib contrib-type="author"><name><surname>Taylor</surname><given-names>John P.</given-names></name><degrees>MBBS(hons), PhD, MRCPsych</degrees><xref ref-type="aff" rid="A17">q</xref></contrib><contrib contrib-type="author"><name><surname>Thomas</surname><given-names>Christine</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A18">r</xref></contrib><contrib contrib-type="author"><name><surname>Tieges</surname><given-names>Zoë</given-names></name><degrees>MA, PhD</degrees><xref ref-type="aff" rid="A11">k</xref></contrib><contrib contrib-type="author"><name><surname>Teodorczuk</surname><given-names>Andrew</given-names></name><degrees>MD, DipClinEd, MRCPsych</degrees><xref ref-type="aff" rid="A19">s</xref></contrib><contrib contrib-type="author"><name><surname>Voyer</surname><given-names>Philippe</given-names></name><degrees>RN, PhD</degrees><xref ref-type="aff" rid="A20">t</xref></contrib><contrib contrib-type="author"><name><surname>Rudolph</surname><given-names>James L.</given-names></name><degrees>MD, SM</degrees><xref ref-type="aff" rid="A21">u</xref><xref ref-type="aff" rid="A22">v</xref></contrib></contrib-group><aff id="A1"><label>a</label>Department of Rehabilitation and Aged Care of the Fondazione Camplani, Ancelle Hospital, Cremona, Italy</aff><aff id="A2"><label>b</label>Geriatric Research Group, Brescia, Italy</aff><aff id="A3"><label>c</label>University College London, London, United Kingdom</aff><aff id="A4"><label>d</label>School of Medicine and Surgery, University of Milano-Bicocca, Milan, and Geriatric Unit, San Gerardo hospital, Monza, Italy</aff><aff id="A5"><label>e</label>Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba Canada; Cardiac Sciences Program, St. Boniface Hospital, Winnipeg, Manitoba, Canada</aff><aff id="A6"><label>f</label>Department of Geriatric Medicine, Prince of Wales Hospital, Sydney, Australia Prince of Wales Clinical School, University of New South Wales, Sydney, Australia</aff><aff id="A7"><label>g</label>Department of Psychiatry, University of California at San Francisco, San Francisco, CA</aff><aff id="A8"><label>h</label>College of Nursing and College of Medicine, The Pennsylvania State University, University Park, PA</aff><aff id="A9"><label>i</label>Penn State College of Nursing, The Pennsylvania State University, University Park, PA</aff><aff id="A10"><label>j</label>Department of Psychiatry and Psychotherapy, Bethel EvangelischesKrankenhaus, Bielefeld, Germany</aff><aff id="A11"><label>k</label>Edinburgh Delirium Research Group, University of Edinburgh, Edinburgh, United Kingdom</aff><aff id="A12"><label>l</label>Graduate-entry Medical School, Cognitive Impairment Research Group, Center for Interventions in Infection, Inflammation and Immunity, Graduate Entry Medical School, University of Limerick, Limerick, Ireland</aff><aff id="A13"><label>m</label>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD</aff><aff id="A14"><label>n</label>Department of Anesthesiology, Division of Critical Care, Vanderbilt University School of Medicine, and the Anesthesia Service, Department of Veterans Affairs, Tennessee Valley Healthcare System</aff><aff id="A15"><label>o</label>Institute of Neuroscience, Newcastle University, Newcastle-upon-Tyne, United Kingdom</aff><aff id="A16"><label>p</label>Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht, The Netherlands</aff><aff id="A17"><label>q</label>Campus for Ageing and Vitality, Newcastle University, Newcastle-upon-Tyne, United Kingdom</aff><aff id="A18"><label>r</label>Department of Psychiatry and Psychotherapy of the Aged, Center of Mental Health, Klinikum Stuttgart, Germany</aff><aff id="A19"><label>s</label>School of Medicine and Health Institute for the Development of Education and Scholarship (HEALTH IDEAS), Griffith University, Queensland, Australia</aff><aff id="A20"><label>t</label>Laval University, Quebec City, Canada Center for Excellence in Aging-Research Unit, Quebec City, Canada</aff><aff id="A21"><label>u</label>Center of Innovation in Long-Term Services and Supports, Providence VA Medical Center, Providence, RI</aff><aff id="A22"><label>v</label>Warren Alpert School of Medicine at Brown University, Providence, RI</aff><author-notes><corresp id="FN1"><label>*</label>Address correspondence to Alessandro Morandi, MD, MPH, Department of Rehabilitation and Aged Care of the Fondazione Camplani, Ancelle Hospital, Via Aselli 16, Cremona, Italy 26100. <email>morandi.alessandro@gmail.com</email> (A. Morandi)</corresp></author-notes><pub-date pub-type="nihms-submitted"><day>15</day><month>2</month><year>2017</year></pub-date><pub-date pub-type="epub"><day>16</day><month>9</month><year>2016</year></pub-date><pub-date pub-type="ppub"><month>1</month><year>2017</year></pub-date><pub-date pub-type="pmc-release"><day>30</day><month>3</month><year>2017</year></pub-date><volume>18</volume><issue>1</issue><fpage>12</fpage><lpage>18</lpage><pmc-comment>elocation-id from pubmed: 10.1016/j.jamda.2016.07.014</pmc-comment>
<abstract><p id="P1">Delirium occurring in patients with dementia is referred to as delirium superimposed on dementia (DSD). People who are older with dementia and who are institutionalized are at increased risk of developing delirium when hospitalized. In addition, their prior cognitive impairment makes detecting their delirium a challenge. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and the International Statistical Classification of Diseases and Related Health Problems, 10th Revision are considered the standard reference for the diagnosis of delirium and include criteria of impairments in cognitive processes such as attention, additional cognitive disturbances, or altered level of arousal. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and the International Statistical Classification of Diseases and Related Health Problems, 10th Revision does not provide guidance regarding specific tests for assessment of the cognitive process impaired in delirium. Importantly, the assessment or inclusion of preexisting cognitive impairment is also not addressed by these standards. The challenge of DSD gets more complex as types of dementia, particularly dementia with Lewy bodies, which has features of both delirium and dementia, are considered. The objective of this article is to critically review key elements for the diagnosis of DSD, including the challenge of neuropsychological assessment in patients with dementia and the influence of particular tests used to diagnose DSD. To address the challenges of DSD diagnosis, we present a framework for guiding the focus of future research efforts to develop a reliable reference standard to diagnose DSD. A key feature of a reliable reference standard will improve the ability to clinically diagnose DSD in facility-based patients and research studies.</p></abstract><kwd-group><kwd>Delirium</kwd><kwd>dementia</kwd><kwd>diagnosis</kwd><kwd>delirium superimposed on dementia</kwd><kwd>Alzheimer disease</kwd><kwd>Lewy Body dementia</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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