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A retrospective multicentre cohort study of the performances on attention tests in outpatients with cognitive dysfunctions without delirium

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Abstract

Objective

Attention is the cardinal feature of delirium, but attentional domains may also be affected by dementia and its severity. It is, therefore, of interest to study the correlation between the severity of cognitive impairment in non-delirious patients and different measurements of attentional performance, to identify attention subdomains less affected by severity of cognitive impairment.

Methods

Neuropsychological data from non-delirious outpatients (age ≥ 65 years), presenting at two memory clinics were analysed retrospectively. Scores for selective, divided, and sustained attention were correlated with cognitive impairment as defined by the score of the Mini-Mental State Examination.

Results

A total of 1658 outpatients were included. The mean age was 77.15 (± 8.17) years, with a mean MMSE score of 22.67 (± 4.91). Compared to the type of attention, the tests that are less influenced by the severity of cognitive impairment are those of selective attention, in particular the Digit Span Forward (DSF).

Conclusions

This is the first study to correlate deficits in attention subdomains with the degree of cognitive impairment in non-delirious patients. The results suggest that measurements of selective attention (i.e. DSF) might be better suited to discriminate delirium from dementia. Indeed, a lower score on these tests might be indicative of an acute change and worsening of the baseline inattention and a longitudinal monitoring of these changes might be used to determine the delirium resolution.

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Authors and Affiliations

  1. Department of Rehabilitation, Fondazione Camplani Casa Di Cura “Ancelle Della Carità” Cremona, Cremona, Italy

    Eleonora Grossi, Elena Lucchi, Simona Gentile & Alessandro Morandi

  2. Geriatric Research Group, Brescia, Italy

    Giuseppe Bellelli, Simona Gentile & Alessandro Morandi

  3. School of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy

    Giuseppe Bellelli

  4. Acute Geriatric Unit, San Gerardo Hospital, Monza, Italy

    Giuseppe Bellelli

  5. Division of Geriatric Psychiatry, Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Bielefeld, Germany

    Stefan H. Kreisel, Max Toepper & Sebastian Boedecker

  6. Parc Sanitari Pere Virgili, Barcelona, Catalonia, Spain

    Marco Inzitari & Alessandro Morandi

Authors
  1. Eleonora Grossi
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  2. Elena Lucchi
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  3. Stefan H. Kreisel
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  4. Max Toepper
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  5. Sebastian Boedecker
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  6. Marco Inzitari
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  7. Giuseppe Bellelli
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  8. Simona Gentile
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  9. Alessandro Morandi
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Corresponding author

Correspondence to Alessandro Morandi.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved and reviewed by the local ethical committee.

Statement of human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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The consent was waved due to the retrospective nature of the study.

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Appendix

Appendix

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Table 5 Description of characteristics of the sample, clustered according to the MMSE score
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5.

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Grossi, E., Lucchi, E., Kreisel, S.H. et al. A retrospective multicentre cohort study of the performances on attention tests in outpatients with cognitive dysfunctions without delirium. Aging Clin Exp Res 34, 39–48 (2022). https://doi.org/10.1007/s40520-021-01891-2

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  • DOI: https://doi.org/10.1007/s40520-021-01891-2

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