Outcome of delirium: part 2. Clinical features of reversible cognitive dysfunction--are they the same as accepted definitions of delirium?

Abstract

To describe the clinical features of reversible cognitive dysfunction. Prospective cohort study. Acute geriatric inpatient units. A random sample of consecutive acute admissions of patients over the age of 65 (N = 80). Serial assessments of mental state and cognitive function and observational data. Patients with more than five points of 20% improvement in Mini Mental State Examination following the most severely impaired assessment operationally designated 'reversible cognitive dysfunction'. The clinical features of those with RCD are compared with those with non-reversible cognitive dysfunction. Delusions, hallucinations, aggression, excitement, irritability and other 'active' symptoms were not commoner in RCD than in non-reversible cognitive dysfunction (non-RCD). By contrast, 'quiet' signs, such as plucking at bedclothes, poor attention, incoherent speech, abnormal associations, slow, vague thought and fluctuating mental state were more marked in RCD than in non-RCD. Reversible cognitive dysfunction is a quiet and unobtrusive disorder.