OBJECTIVES To compare the etiology, phenomenology and motor subtype of delirium in patients with and without an underlying dementia. METHODS A combined dataset (n = 992) was collated from two databases of older adults (>65 years) from liaison psychiatry and palliative care populations in Ireland and India. Phenomenology and severity of delirium were analysed using the Delirium Symptom Rating Scale Revised (DRS-R98) and contributory etiologies for the delirium groups were ascertained using the Delirium Etiology Checklist (DEC). Delirium motor subtype was documented using the abbreviated version of the Delirium Motor Subtype Scale (DMSS4). RESULTS Delirium superimposed on dementia (DSD) showed greater impairment in short term memory, long term memory and visuospatial ability than the delirium group but showed significantly less perceptual disturbance, temporal onset and fluctuation. Systemic infection, cerebrovascular and other Central nervous system etiology were associated with DSD while metabolic disturbance, organ insufficiency and intracranial neoplasm were associated with the delirium only group. CONCLUSION The etiology and phenomenology of delirium differs when it occurs in the patient with an underlying dementia. We discuss the implications in terms of identification and management of this complex condition.

中文翻译：

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当患有潜在痴呆症的患者发生谵妄时，其病因、现象学和运动亚型是否有所不同？：一项多中心国际研究。

目的 比较患有和不患有潜在痴呆症的患者谵妄的病因、现象学和运动亚型。方法 从爱尔兰和印度联络精神病学和姑息治疗人群的两个老年人（> 65 岁）数据库中整理出一个组合数据集（n = 992）。使用谵妄症状评定量表修订版 (DRS-R98) 分析谵妄的现象学和严重程度，并使用谵妄病因检查表 (DEC) 确定谵妄组的病因。使用谵妄运动亚型量表 (DMSS4) 的缩写版本记录谵妄运动亚型。结果 与谵妄组相比，痴呆叠加谵妄（DSD）患者的短期记忆、长期记忆和视觉空间能力受损程度更大，但知觉障碍、时间发作和波动明显较少。全身感染、脑血管和其他中枢神经系统病因与 DSD 相关，而代谢紊乱、器官功能不全和颅内肿瘤与仅谵妄组相关。结论 当谵妄发生在患有潜在痴呆症的患者身上时，谵妄的病因和现象有所不同。我们讨论了这种复杂情况的识别和管理方面的影响。