Early diagnosis of delirium in elderly patients with acute stroke

Abstract

Delirium is a common of stroke complication that aggravates the patient’s prognosis. The aim of this study was to identify the groups that are at risk of developing delirium among elderly patients with acute stroke and assess the diagnostic value of the 4-A test in identifying delirium in this category of patients. In total, 73 patients were included in the study; 33 of them (45%) had the symptoms of delirium, according to the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV). Delirious patients had more severe neurological deficit and more prominent chronic changes in the brain on CT images; they also had more frequently positive primitive reflexes and a higher erythrocyte sedimentation rate. All six patients with pneumonia were delirious. The Russian version of the 4-A test demonstrated good psychometric properties. Thus, the risk of developing delirium in elderly patients in the acute period of stroke is increased in cases of severe strokes, in the presence of chronic changes in the brain according to CT and clinical examination, and inflammatory complications. The targeted screening of patients with the indicated risk factors using tools such as 4-AT will allow delirium to be identified more efficiently and quickly in its early stages in elderly patients with acute stroke.