ArticleJournal of the American Medical Directors Association2019
Ultra-brief Screeners for Detecting Delirium Superimposed on Dementia.
Article in Journal of the American Medical Directors Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 17 citations in OpenAlex.
- [Delirium superimposed on dementia : Early detection and treatment].Zeitschrift fur Gerontologie und Geriatrie · 2023Review
- Comparative Implementation of a Brief App-Directed Protocol for Delirium Identification by Hospitalists, Nurses, and Nursing Assistants : A Cohort Study.Annals of internal medicine · 2022Article
- Current Challenges in the Recognition and Management of Delirium Superimposed on Dementia.Neuropsychiatric disease and treatment · 2021Review
- Delirium: A Marker of Vulnerability in Older People.Frontiers in aging neuroscience · 2021Review
- Delirium Assessment in Critically Ill Older Adults: Considerations During the COVID-19 Pandemic.Critical care clinics · 2021Review
- Ultrabrief Screens for Detecting Delirium in Postoperative Cognitively Intact Older Adults.Journal of hospital medicine · 2020Article
- Delirium awareness day: a portuguese perspective.Porto biomedical journalArticle
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveDelirium superimposed on dementia (DSD) is common, morbid, and costly, yet frequently undiagnosed. Our study aimed to develop a brief screening test to improve health care worker recognition of DSD. DESIGN/SETTING/
participantsOlder hospitalized adults with dementia were prospectively enrolled from medical and surgical inpatient units of 3 hospitals (2 in Pennsylvania, 1 in Tennessee). MEASURES: The reference standard delirium assessment used Confusion Assessment Method (CAM) criteria and was based on a structured interview including the Mini-Mental State Examination, interviewer observations, and medical record review. To develop the screening test, 1-, 2-, and 3-item combinations from the reference standard assessment were analyzed to determine their sensitivity and specificity in diagnosing delirium presence in a dementia population compared to the reference standard. For multiple-item screeners, error on 1 or more items was considered a positive screen.
resultsOverall, 391 older adults with dementia were enrolled (mean age: 83.9 years, 71.1% female), and 95 (24.4%) developed DSD during their hospitalization, based on the reference standard. The best single-item screen for DSD was "What day of the week is it?" with 84% sensitivity [95% confidence interval (CI): 0.75, 0.91] and 41% specificity (CI: 0.35, 0.47). The best 2-item screen was "list the days of the week backwards" and "What day of the week is it?" with 93% sensitivity (CI: 0.85, 0.97) and 30% specificity (CI: 0.25, 0.36). The best 3-item screen was "list the days of the week backwards," "What type of place is this? [hospital]" and "Does the patient appear sleepy?" with 94% sensitivity (CI: 0.87, 0.98) and 42% specificity (CI: 0.36, 0.48). CONCLUSIONS/IMPLICATIONS: We identified a 3-item DSD screener with excellent sensitivity but limited specificity. This screener can be used to quickly rule out DSD in populations with a high prevalence of dementia and is a promising step toward developing efficient tools for DSD recognition among care providers.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.