Informant single screening questions for delirium and dementia in acute care – a cross-sectional test accuracy pilot study

BMC Geriatrics

Research Article

Terence J Quinn¹  Kirsty Hendry²  David J Stott³  Jonathan J Evans⁴ 

[1] Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK;Academic Section of Geriatric Medicine, Institute of Cardiovascular and Medical Sciences, Room 2.44, 2nd floor New Lister Building Glasgow Royal Infirmary, G31 2ER, Glasgow, UK;Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK;Academic Section of Geriatric Medicine, Institute of Cardiovascular and Medical Sciences, Room 2:03, 2nd floor New Lister Building Glasgow Royal Infirmary, G31 2ER, Glasgow, UK;Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK;Academic Section of Geriatric Medicine, Institute of Cardiovascular and Medical Sciences, Room 9, 2nd floor New Lister building Glasgow Royal Infirmary, G31 2ER, Glasgow, UK;Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK;Mental Health and Wellbeing, University of Glasgow, The Academic Centre, Gartnavel Royal Hospital, R212 Level 2, 1055 Great Western Road, G12 0XH, Glasgow, UK;

关键词: Dementia;    Delirium;    Cognitive screening;    Geriatrics;    Psychology;   

DOI  :  10.1186/s12877-015-0016-1

 received in 2014-10-17, accepted in 2015-02-16,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundCognitive impairment often goes undetected in older people in hospital. Efficient screening tools are required to improve detection.To determine diagnostic properties of two separate informant-based single screening questions for cognitive impairment (dementia and delirium) in hospitalised older people.MethodsPatients over 65 years non-electively admitted to medical or geriatric wards within a teaching hospital. Our index tests were single screening questions (SSQ), one for dementia (“How has your relative/friend’s memory changed over the past 5 years (up to just before their current illness)?”) and one for delirium (“How has your relative/friend’s memory changed with his/her current illness?”), which were assessed with informant response given on a five point Likert scale.Any deterioration on our index tests of SSQ-dementia and SSQ-delirium was accepted as a positive screen for cognitive impairment. Scores were compared to the Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE) >3.38 accepted as dementia, and Confusion Assessment Method (CAM) diagnosis of delirium. We also collected direct cognitive screening data using Mini Mental Status Examination (MMSE).ResultsInformant responses were obtained in 70/161 (43.5%) patients, median age 80.8 (range:67–97) years; mean MMSE score 18.5 (SD: 8.1). The SSQ-dementia when compared to the IQCODE had a sensitivity of 83.3% and specificity of 93.1%. The SSQ-delirium when compared to CAM diagnosis had sensitivity of 76.9% and a specificity of 56.1%.ConclusionsThese findings show promise for use of an informant single screening question tool as the first step in detection of dementia in older people in acute hospital care, although this approach appears to be less accurate in screening for delirium.

【 授权许可】

CC BY   
© Hendry et al.; licensee BioMed central. 2015