<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_1905-7415.0904.413_s_001_w2aab3b7b1b1b6b1aab1c16b1Aa"><h3>Background</h3><p>The occurrence of delirium superimposed on dementia (DSD) in patients with hip fracture may have many life-threatening complications, especially if unrecognized and untreated.</p></sec><sec id="j_1905-7415.0904.413_s_002_w2aab3b7b1b1b6b1aab1c16b2Aa"><h3>Objectives</h3><p>To estimate the prevalence and outcomes of DSD in hospitalized elderly adults with dementia and hip fracture, and clinical symptoms of delirium with and without dementia.</p></sec><sec id="j_1905-7415.0904.413_s_003_w2aab3b7b1b1b6b1aab1c16b3Aa"><h3>Methods</h3><p>The review process followed guidelines consisting of 5 steps suggested for systematic reviews. Relevant studies between January 2000 to December 2014 were obtained from electronic databases, and 2 trained reviewers independently analyzed them. Comprehensive Meta-Analysis software (Biostat) was used to assess and combine the data across studies.</p></sec><sec id="j_1905-7415.0904.413_s_004_w2aab3b7b1b1b6b1aab1c16b4Aa"><h3>Results</h3><p>We identified 15 articles for meta-analysis. Prevalence of DSD after hip fracture was 69.7% (95% confidence interval [CI] = 60.4%-77.7%). People with dementia after hip fracture had a 6.03 times higher likelihood of sustaining delirium than those without dementia (95% CI = 3.63%-10.04%). The symptoms of delirium in a person without dementia was more often any hyperactivity (ES = 2.27, 95% CI = 1.17-4.41, P = 0.015), but those lacking dementia were more often hypoactive (ES = 2.22, 95% CI = 1.15-4.56, P = 0.018). There was limited evidence of publication bias, and there was substantial selective reporting bias in articles.</p></sec><sec id="j_1905-7415.0904.413_s_005_w2aab3b7b1b1b6b1aab1c16b5Aa"><h3>Conclusions</h3><p>The review demonstrates the high prevalence of DSD and highlights the differences in motor subtypes of delirium between delirium with and without dementia, but there is concern about these results given the high risk of bias.</p></sec></abstract>

BackgroundThe occurrence of delirium superimposed on dementia (DSD) in patients with hip fracture may have many life-threatening complications, especially if unrecognized and untreated.ObjectivesTo estimate the prevalence and outcomes of DSD in hospitalized elderly adults with dementia and hip fracture, and clinical symptoms of delirium with and without dementia.MethodsThe review process followed guidelines consisting of 5 steps suggested for systematic reviews. Relevant studies between January 2000 to December 2014 were obtained from electronic databases, and 2 trained reviewers independently analyzed them. Comprehensive Meta-Analysis software (Biostat) was used to assess and combine the data across studies.ResultsWe identified 15 articles for meta-analysis. Prevalence of DSD after hip fracture was 69.7% (95% confidence interval [CI] = 60.4%-77.7%). People with dementia after hip fracture had a 6.03 times higher likelihood of sustaining delirium than those without dementia (95% CI = 3.63%-10.04%). The symptoms of delirium in a person without dementia was more often any hyperactivity (ES = 2.27, 95% CI = 1.17-4.41, P = 0.015), but those lacking dementia were more often hypoactive (ES = 2.22, 95% CI = 1.15-4.56, P = 0.018). There was limited evidence of publication bias, and there was substantial selective reporting bias in articles.ConclusionsThe review demonstrates the high prevalence of DSD and highlights the differences in motor subtypes of delirium between delirium with and without dementia, but there is concern about these results given the high risk of bias.

Hyperactive and hypoactive psychomotor subtypes of delirium in demented and nondemented elderly patients with hip fractures: systematic review and meta-analysis

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

BackgroundThe occurrence of delirium superimposed on dementia (DSD) in patients with hip fracture may have many life-threatening complications, especially if...

Hyperactive and hypoactive psychomotor subtypes of delirium in demented and nondemented elderly patients with hip fractures: systematic review and meta-analysis

Article Category: Review article

Published Online: Jan 31, 2017

Page range: 441 - 453

DOI: https://doi.org/10.5372/1905-7415.0904.413

Keywords
Delirium, dementia, hip fracture

© 2015 Sunee Suwanpasu, Youwanuch Sattayasomboon

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Hyperactive and hypoactive psychomotor subtypes of delirium in demented and nondemented elderly patients with hip fractures: systematic review and meta-analysis

Article Category: Review article

Published Online: Jan 31, 2017

Page range: 441 - 453

DOI: https://doi.org/10.5372/1905-7415.0904.413

KeywordsDelirium, dementia, hip fracture

© 2015 Sunee Suwanpasu, Youwanuch Sattayasomboon

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
Delirium, dementia, hip fracture