Seventy elderly patients meeting the DSM-III criteria for delirium were examined during the acute stage and followed up to one year. The mean age of the patients was 75 years (range 60-88), their delirium lasted on average 20 days (range 3-81) and the psychiatric hospitalization on average 30 days (range 8-365). The most common etiologies for delirium were stroke, infections and metabolic disorders. For 57 cases (81%) a predisposing structural brain disease was found. During the index admission, the cognitive dysfunction associated with delirium ameliorated significantly (the mean +/- SD Mini-Mental State Examination score 9.7 +/- 6.6 at admission and 13.9 +/- 7.2 at discharge; P less than 0.001), but during the one-year follow-up progression of the basic central nervous system disease was seen together with declining cognition and deterioration of functions of daily living.

No abstract

No abstract

No abstract

Computered tomography of the head was carried out on 35 patients who received a hospital diagnosis of delirium according to the DSM-III, and 25 controls without cognitive disturbance. There were no statistically significant differences in the mean age of the groups or in the cortical atrophy score as measured by the mean width of the four largest sulci in the three uppermost tomographic cuts. Instead, the delirious patients differed from the controls in the frontal horn and cella media indices, in the width of the third ventricle and Sylvian fissure at insula on the left side. There was also a significant excess of low attenuation, brain infarct-type areas in the delirious patients. The study confirms the marked predisposing role of the structural brain diseases (primary degenerative and multi-infarct type dementias, Parkinsonism) in the development of acute delirium in elderly patients.