Associação entre delirium e demência nos idosos

Abstract

Introduction: Delirium is a neuropsychiatric syndrome, characterised by an acute change in mental status with a fluctuating course of symptoms, that affects almost 50% of people aged 65 years or older, admitted to hospital. Delirium is associated with increased risk of mortality, cognitive decline. In 50% of the cases, the cause of delirium is multifactorial, resulting from a complex inter-relationship between several predisposing factors in highly vulnerable patients that are exposed to precipitating factors. There is an interrelation between delirium and dementia. Delirium could be a marker of vulnerability to dementia, might unmask dementia, or might itself leads to dementia. Materials and Methods: The articles obtained for this narrative literature review were searched in PubMed using the MesH terms "delirium", "dementia". Recent articles were considered, particularly systematic reviews focusing on the relationship between delirium and dementia. This review will describe and discuss the state of the art about this specific topic, considering the following topics: delirium and dementia - differential diagnosis; dementia as a risk factor for delirium; delirium as a risk factor for dementia. Results: Revision on a theme. Discussion: Studies demonstrate that patients with dementia who develop delirium have higher rates of hospitalization readmission, mortality, institutionalization and worsening of cognitive decline. Conclusion: The identification of risk factors for delirium, specifically pre-existing cognitive impairment or dementia, in elderly people admitted to hospital is essential to the implementation of preventive strategies that may contribute to the decrease of delirium rates.