Abstract
Behavioral and psychological symptoms of dementia (BPSD) and delirium are common in advanced phases of Alzheimer's disease (AD). Thirty-eight moderate-severe AD patients were enrolled (n=16 affected by type 2 diabetes). Each patient received a comprehensive geriatric assessment (CGA) (including evaluation of BPSD and frailty), and a complete metabolic evaluation (including the measurement of the glycated hemoglobin, HbA1c). Both the hyper- and hypo-glycemic extremes of the glycemic spectrum worsened BPSD, but delirium was more susceptible to hypoglycemic events. The severity of delirium was significantly related to cognitive function (r = -0.585, p<0.001) and frailty (r = +0.440, p<0.05). The measurement of HbA1c was useful for evaluating the risk of delirium in relationship to glycemic control and nutritional status.
Highlights
Behavioral and psychological symptoms of dementia (BPSD) and delirium are common in advanced phases of Alzheimer’s disease (AD)
In our preliminary study, polypathology and frailty was associated with the severity of delirium as demonstrated by using the Marigliano-Cacciafesta polypathology scale (MCPS) scale in correlation with the CAM-S scale
To the best of our knowledge this is the first report about the association of the MCPS and CAM-S scale, whereas the MCPS was previously evaluated by our group in patients with comorbidities and frailty[9]
Summary
Behavioral and psychological symptoms of dementia (BPSD) and delirium are common in advanced phases of Alzheimer’s disease (AD). Methods: Thirty-eight moderate-severe AD patients were enrolled (n=16 affected by type 2 diabetes). Each patient received a comprehensive geriatric assessment (CGA) (including evaluation of BPSD and frailty), and a complete metabolic evaluation (including the measurement of the glycated hemoglobin, HbA1c). Results: Both the hyper- and hypo-glycemic extremes of the glycemic spectrum worsened BPSD, but delirium was more susceptible to hypoglycemic events. The severity of delirium was significantly related to cognitive function (r = -0.585, p
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