Subsyndromal delirium in older people: a systematic review of frequency, risk factors, course and outcomes

International Journal of Geriatric Psychiatry - Tập 28 Số 8 - Trang 771-780 - 2013
Martín G. Cole1,2,3, Antonio Ciampi4,3, Éric Belzile3, Marika Dubuc‐Sarrasin3
1Department of Psychiatry, McGill University, Montreal, QC, Canada
2Department of Psychiatry, St. Mary's Hospital Center, Montreal, QC, Canada
3St. Mary's Research Center, St. Mary's Hospital Center, Montreal, QC, Canada
4Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada

Tóm tắt

ObjectiveTo determine the frequency, risk factors, course and outcomes of subsyndromal delirium (SSD) in older people by systematically reviewing evidence on these topics.MethodsSubsyndromal delirium was defined as the presence of one or more symptoms of delirium, not meeting criteria for delirium and not progressing to delirium. MEDLINE, EMBASE, PsycINFO and the Web of Science were searched for potentially relevant articles published from 1996 to June 2011. The bibliographies of relevant articles were searched for additional references. Twelve studies met the inclusion criteria. The validity of included studies was assessed according to Evidence‐Based Medicine criteria. Information about the study population and methods, age, gender, proportion with dementia, diagnostic criteria, period and frequency of observation, and the topics above was systematically abstracted, tabulated and synthesized using standard meta‐analysis techniques.ResultsThe combined prevalence of SSD was 23% (95% CI, 9–42%); the combined incidence was 13% (95% CI, 6–23%). Risk factors were similar to those for delirium. Episodes lasted up to 133 days and were often recurrent. Outcomes were poor and often intermediate between those of older people with or without delirium. Of note, there was significant unexplained heterogeneity in the results of studies of prevalence, incidence and some risk factors.ConclusionsSSD in older people may be a frequent and clinically important condition that falls on a continuum between no symptoms and full delirium. Because of significant unexplained heterogeneity in the results of studies of SSD, however, the results of this review must be interpreted cautiously. Further research is necessary. Copyright © 2012 John Wiley & Sons, Ltd.

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International Journal of Geriatric Psychiatry

Tập 28 Số 8

771-780

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