History of a suspected delirium is more common in dementia with Lewy bodies than Alzheimer's disease: a retrospective study

Authors

  • Emma Vardy,

    Corresponding author
    1. Department of Older Peoples Medicine, Newcastle upon Tyne hospitals NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, UK
    2. Institute of Ageing and Health, Campus of Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
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  • Rachel Holt,

    1. Department of Elderly Medicine, Pinderfields Hospital, Mid Yorkshire Hospitals NHS Trust, Wakefield, UK
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  • Alex Gerhard,

    1. Centre for clinical and cognitive Neurosciences, Institute of Brain Behaviour and Mental Health, University of Manchester, Manchester, UK
    2. Cerebral Function Unit, Salford Royal NHS Foundation Trust, Salford, UK
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  • Anna Richardson,

    1. Centre for clinical and cognitive Neurosciences, Institute of Brain Behaviour and Mental Health, University of Manchester, Manchester, UK
    2. Cerebral Function Unit, Salford Royal NHS Foundation Trust, Salford, UK
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  • Julie Snowden,

    1. Centre for clinical and cognitive Neurosciences, Institute of Brain Behaviour and Mental Health, University of Manchester, Manchester, UK
    2. Cerebral Function Unit, Salford Royal NHS Foundation Trust, Salford, UK
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  • David Neary

    1. Centre for clinical and cognitive Neurosciences, Institute of Brain Behaviour and Mental Health, University of Manchester, Manchester, UK
    2. Cerebral Function Unit, Salford Royal NHS Foundation Trust, Salford, UK
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Abstract

Background

Delirium is common and is associated with an increased risk of dementia. However, it is not clear whether delirium confers increased risk of any particular type of dementia. We performed a retrospective study of Alzheimer's disease (AD) and Dementia with Lewy bodies (DLB) to ascertain whether a suspected episode of preceding delirium was more common prior to diagnosis in either type of dementia.

Methods

The study was carried out in a tertiary referral unit for the diagnosis of dementia. Clinic letters from the first presentation to the unit of 85 cases with DLB and 95 cases of AD were reviewed for documentation of any previous episodes of suspected delirium.

Results

In this study, 25% of DLB cases had at least one reported episode of suspected delirium as compared to 7% of AD cases (p = 0.001). For the DLB cases who had a prior suspected delirium, 23% had more than one episode compared with 14% of the AD group. The median time between most recent suspected episode of delirium and diagnosis of dementia in both groups was less than a year

Conclusions

A greater proportion of those presenting and diagnosed with DLB had a documentation of a suspected delirium than those diagnosed with AD. Delirium may lead to a higher risk of DLB as opposed to other forms of dementia, or delirium may, at least in some cases, represent the early stages of DLB. These data suggest that a diagnosis of DLB should be specifically considered in those presenting with a delirium. Copyright © 2013 John Wiley & Sons, Ltd.

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