OBJECTIVES Few studies have analyzed factors associated with delirium subtypes. In this study, we investigate factors associated with subtypes of delirium only in patients with dementia to provide insights on the possible prevention and treatments. DESIGN This is a cross-sectional study nested in the "Delirium Day" study, a nationwide Italian point-prevalence study. SETTING AND PARTICIPANTS Older patients admitted to 205 acute and 92 rehabilitation hospital wards. MEASURES Delirium was evaluated with the 4-AT and the motor subtypes with the Delirium Motor Subtype Scale. Dementia was defined by the presence of a documented diagnosis in the medical records and/or prescription of acetylcholinesterase inhibitors or memantine prior to admission. RESULTS Of the 1057 patients with dementia, 35% had delirium, with 25.6% hyperactive, 33.1% hypoactive, 34.5% mixed, and 6.7% nonmotor subtype. There were higher odds of having venous catheters in the hypoactive (OR 1.82, 95% CI 1.18-2.81) and mixed type of delirium (OR 2.23, CI 1.43-3.46), whereas higher odds of urinary catheters in the hypoactive (OR 2.91, CI 1.92-4.39), hyperactive (OR 1.99, CI 1.23-3.21), and mixed types of delirium (OR 2.05, CI 1.36-3.07). We found higher odds of antipsychotics both in the hyperactive (OR 2.87, CI 1.81-4.54) and mixed subtype (OR 1.84, CI 1.24-2.75), whereas higher odds of antibiotics was present only in the mixed subtype (OR 1.91, CI 1.26-2.87). CONCLUSIONS AND IMPLICATIONS In patients with dementia, the mixed delirium subtype is the most prevalent followed by the hypoactive, hyperactive, and nonmotor subtype. Motor subtypes of delirium may be triggered by clinical factors, including the use of venous and urinary catheters, and the use of antipsychotics. Future studies are necessary to provide further insights on the possible pathophysiology of delirium in patients with dementia and to address the optimization of the management of potential risk factors.

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了解老年痴呆症住院患者精神运动性谵妄亚型的相关因素

目的 很少有研究分析与谵妄亚型相关的因素。在这项研究中，我们仅在痴呆患者中调查与谵妄亚型相关的因素，以提供有关可能的预防和治疗的见解。设计 这是一项横断面研究，嵌套在“谵妄日”研究中，这是一项意大利全国性点流行率研究。地点和参与者 入住 205 个急症病房和 92 个康复病房的老年患者。测量 使用 4-AT 评估谵妄，使用谵妄运动亚型量表评估运动亚型。痴呆症的定义是入院前在医疗记录中记录的诊断和/或乙酰胆碱酯酶抑制剂或美金刚的处方。结果 1057 例痴呆患者中，35% 有谵妄，25.6% 多动，33。1% 活动减退，34.5% 混合，6.7% 非运动亚型。在低活性（OR 1.82，95% CI 1.18-2.81）和混合型谵妄（OR 2.23，CI 1.43-3.46）中使用静脉导管的几率更高，而在低活性（OR 2.91， CI 1.92-4.39）、过度活跃（OR 1.99、CI 1.23-3.21）和混合型谵妄（OR 2.05、CI 1.36-3.07）。我们发现在过度活跃 (OR 2.87, CI 1.81-4.54) 和混合亚型 (OR 1.84, CI 1.24-2.75) 中使用抗精神病药的几率更高，而仅在混合亚型 (OR 1.91, CI 1.26) 中使用抗生素的几率更高-2.87）。结论和意义 在痴呆患者中，混合性谵妄亚型最为普遍，其次是活动减退、活动过度和非运动亚型。谵妄的运动亚型可能由临床因素触发，包括使用静脉和导尿管，以及使用抗精神病药。未来的研究需要进一步了解痴呆患者谵妄的可能病理生理学，并优化潜在危险因素的管理。