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Inicio Medicina Clínica (English Edition) Diagnosing delirium in patients with dementia, a great challenge
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Vol. 153. Issue 7.
Pages 284-289 (October 2019)
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Vol. 153. Issue 7.
Pages 284-289 (October 2019)
Review
Diagnosing delirium in patients with dementia, a great challenge
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...
Neus Guala,b,
Corresponding author
ngual@perevirgili.cat

Corresponding author.
, Marta García-Salmonesa, Laura M. Péreza
a Parc Sanitari Pere Virgili, Barcelona, Spain
b Universitat Autònoma de Barcelona, Barcelona, Spain
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Tables (3)
Table 1. Diagnostic criteria for delirium according to the DSM-V and ICD-10.
Table 2. Sensitivity and specificity of Confusion Assessment Method and its variants in the diagnosis of delirium superimposed on dementia.
Table 3. New tools for the diagnosis of delirium superimposed on dementia.
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Abstract

Delirium, despite its high incidence, serious consequences and potential reversibility, remains an underdiagnosed syndrome. In patients with dementia, the healthcare professional may find significant difficulties in differentiating whether the patient presents cognitive alterations and behavioural disorders characteristic of dementia or, on the contrary, is faced with a delirium superimposed on dementia (DSD). In view of this difficulty, many tools have been proposed in recent years to improve the diagnosis of DSD in these highly complex patients. The aim of these tools is to be easy and quick to apply, and although focusing on assessing cognitive aspects such as attention or level of consciousness, some of them have also incorporated the assessment of other more novel aspects, such as the ability to respond to external stimuli (Arousal) or the degree of mobility.

Keywords:
Delirium
Delirium superimposed on dementia
Diagnosis
Resumen

El delirium, a pesar de su alta incidencia, graves consecuencias y potencial reversibilidad, sigue siendoun síndrome infradiagnosticado. En pacientes con demencia, el profesional sanitario puede encontrardificultades para diferenciar si el paciente presenta alteraciones cognitivas y trastornos conductualespropios de la demencia o, por el contrario, se encuentra ante un cuadro de delirium superpuesto a lademencia (DSD). Ante esta dificultad, se han propuesto en los últimos años distintas herramientas paramejorar el diagnóstico de DSD. Estas herramientas intentan ser fáciles y rápidas de aplicar, y a pesar decentrarse en la evaluación de aspectos cognitivos como la atención o el nivel de consciencia, algunas deellas han incorporado la valoración de otros aspectos más novedosos, como la capacidad de responder aestímulos externos (estado de alerta o activación) o el grado de movilidad.

Palabras clave:
Delirium
Delirium superpuesto a demencia
Diagnóstico

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