Objectives:

There is a knowledge gap on the prognostic significance of subsyndromes of delirium. We describe the association of poststroke attenuated delirium syndrome (ADS) with cognitive, functional, and mortality outcomes at 3 months.

Methods:

A longitudinal observational study in which repeated assessments for delirium symptoms were conducted in the first week of stroke using the confusion assessment method. Attenuated delirium syndrome was characterized in survivors who were free of the full delirium syndrome but had ≥2 core features of delirium. Baseline and follow-up assessments were conducted using the Mini-Mental State Examination (MMSE), 10-word list learning and delayed recall test, Animal naming test, and Barthel index.

Results:

Among 150 participants recruited consecutively over 2 years, ADS was present in 32 (21.3%). Of 121 who were free of the full delirium syndrome, 21 (17.4%) had died by 3 months. Those who survived were more likely to be receiving treatment for systemic hypertension (88.5%, P = .007). In analyses adjusting for the effect of age, economic status, and systemic hypertension, ADS in the first week of stroke predicted cognitive decline at 3 months ([mean difference (MD) in MMSE scores = −3.8, 95% CI = −7.0 to −0.7, P = .019]). However, ADS was not associated with greater decline in activities of daily life (MD = −0.4, 95% CI = −2.8 to 2.0) or significant odds ratio (OR) of mortality (OR = 2.3, 95% CI = 0.8-6.3).

Conclusion:

Attenuated delirium syndrome may be an important marker of cognitive impairment at 3 months poststroke. Its detection may lead to identification of stroke survivors who are likely to benefit from evidence-based preventive interventions for poststroke cognitive decline.

中文翻译：

---

中风幸存者减弱性谵妄综合征的认知、功能和死亡率结果。

目标：

关于谵妄亚综合征的预后意义存在知识空白。我们描述了卒中后减弱性谵妄综合征 (ADS) 与 3 个月时认知、功能和死亡率结果的关联。

方法：

一项纵向观察性研究，在中风的第一周使用混淆评估方法对谵妄症状进行重复评估。轻度谵妄综合征的特征在于幸存者没有完全谵妄综合征，但具有≥2项谵妄的核心特征。使用简易精神状态检查 (MMSE)、10 字列表学习和延迟回忆测试、动物命名测试和 Barthel 指数进行基线和后续评估。

结果：

在连续 2 年招募的 150 名参与者中，有 32 名（21.3%）存在 ADS。在没有完全谵妄综合征的 121 人中，21 人（17.4%）在 3 个月内死亡。那些幸存下来的人更有可能接受全身性高血压治疗（88.5%，P = .007）。在调整年龄、经济状况和全身性高血压影响的分析中，卒中第一周的 ADS 预测了 3 个月时的认知能力下降（[MMSE 评分的平均差 (MD) = -3.8，95% CI = -7.0 至-0.7，P = .019]）。然而，ADS 与日常生活活动（MD = -0.4，95% CI = -2.8 至 2.0）或死亡率的显着优势比（OR）（OR = 2.3，95% CI = 0.8-6.3）无关）。

结论：

轻度谵妄综合征可能是卒中后 3 个月认知障碍的重要标志。它的检测可能会导致识别中风幸存者，他们可能会从基于证据的中风后认知下降预防干预措施中受益。