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ORIGINAL RESEARCH article

Front. Psychiatry
Sec. Aging Psychiatry
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1407213

Circadian disturbances, anxiety and motor disturbances differentiate delirium superimposed on dementia from dementia-only

Provisionally accepted
Thiemo Schnorr Thiemo Schnorr 1,2*Tim Fleiner Tim Fleiner 1,2,3Rieke Trumpf Rieke Trumpf 1,2Christian Prüter-Schwarte Christian Prüter-Schwarte 4Janina Fanselow Janina Fanselow 1Wiebren Zijlstra Wiebren Zijlstra 2Peter Häussermann Peter Häussermann 1
  • 1 Department of Geriatric Psychiatry and Psychotherapy, LVR Clinic Cologne, Cologne, Germany
  • 2 Institute of Movement and Sport Gerontology, German Sport University Cologne, Cologne, North Rhine-Westphalia, Germany
  • 3 Institute for Geriatric Research, Ulm University Medical Center, Ulm, Germany
  • 4 Department of Forensic Psychiatry and Psychotherapy, LVR Clinic Cologne, Cologne, North Rhine-Westphalia, Germany

The final, formatted version of the article will be published soon.

    Background: To ensure adequate treatment, individuals with delirium superimposed on dementia (DSD) need to be differentiated reliably from those with dementia only (DO). Therefore, we aimed to examine the clinical indicators of DSD by assessing motor subtypes, cognitive performance and neuropsychiatric symptoms in DSD and DO patients. Methods: Cross-sectional design with the Delirium-Motor-Subtyping Scale (DMSS), Mini-Mental-State-Examination (MMSE), Clock-Drawing-Test (CDT), DemTect, and Neuropsychiatric Inventory assessed after admission to an acute hospital. Results: 94 patients were included, 43 with DSD (78±7 years, MMSE = 11±9) and 51 with DO (79±7 years, MMSE = 9±8). DMSS "no subtype" was more common in the DO group (26% vs. 10%, p =.04). The DSD group showed lower CDT scores (DSD: M = 4±3 vs. DO: M = 6±1; p<.001) and higher anxiety (DSD: MED = 3±8 vs. DO: MED = 3±4; p=.01) and sleep/night-time behavior disturbances (DSD: MED = 0±6 vs. DO: MED = 0±0; p=.02). Conclusions: Sleep/night-time behavior disturbances appear to be a clinical indicator of DSD. Motor subtypes can identify cases at increased risk of developing delirium or unrecognized delirium. Trial registration: Trial registration number: DRKS00025439 (German Clinical Trials Register).The Ethics Committee of the North Rhine Medical Association approved all procedures (reference number 2018912).

    Keywords: Delirium superimposed on dementia, motor subtypes, Acute hospital, Neuropsychiatric symptoms, Sleep disturbances

    Received: 26 Mar 2024; Accepted: 29 Jul 2024.

    Copyright: © 2024 Schnorr, Fleiner, Trumpf, Prüter-Schwarte, Fanselow, Zijlstra and Häussermann. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Thiemo Schnorr, Department of Geriatric Psychiatry and Psychotherapy, LVR Clinic Cologne, Cologne, Germany

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