The effects of the glycaemic control on the severity of the delirium in the advanced phase of Alzheimer's disease

Abstract

Background: Behavioural and psychological symptoms of dementia (BPSD) and delirium are common in advanced phases of Alzheimer's disease (AD). Methods: Thirty-eight moderate-severe AD patients were enrolled (n=16 affected by type 2 diabetes). Each patient received a comprehensive geriatric assessment (CGA) (including evaluation of BPSD and frailty), and a complete metabolic evaluation (including the measurement of the glycated haemoglobin, HbA1c). Results: Both the hyper- and hypo-glycaemic extremes of the glycaemic spectrum worsened BPSD, but delirium was more susceptible to hypoglycaemic events. The severity of delirium was significantly related to cognitive function (r = -0.585, p<0.001) and frailty (r = +0.440, p<0.05). Conclusions: The measurement of HbA1c was useful for evaluating the risk of delirium in relationship to glycaemic control and nutritional status.