ArticleJournal of the American Geriatrics Society2020
Family Identification of Delirium in the Emergency Department in Patients With and Without Dementia: Validity of the Family Confusion Assessment Method (FAM-CAM).
Article in Journal of the American Geriatrics Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.
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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
27 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- GRADE-Based Clinical Practice Guidelines for Emergency Department Delirium Risk Stratification, Screening, and Brain Imaging in Older Patients With Suspected Delirium.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Guideline
- Barriers to healthcare professionals screening, recognizing, and managing delirium in the adult patients receiving specialist palliative care: a mixed-methods systematic review.BMC palliative care · 2025Pooled it
- Delirium detection in the emergency department: A diagnostic accuracy meta-analysis of history, physical examination, laboratory tests, and screening instruments.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2024Pooled it
- Detection of postoperative delirium by family and caregivers: Evaluation of the family confusion assessment method (FAM-CAM).Journal of clinical anesthesia · 2025Trial
- A Pilot Randomized Controlled Trial Assessing the Feasibility and Acceptability of Family-Partnered Delirium Prevention, Detection, and Management in Critically Ill Adults: The Activating Family Caregivers in the Identification Prevention and Management of Delirium (ACTIVATE) Study.Critical care explorations · 2025Trial
- Early Diagnosis of Delirium in Geriatric Patients in Emergency Departments: A Systematic Review and Meta-Analysis.Brain sciences · 2026Review
- Dementia Caregivers' Preferences for Involvement in Delirium Care During Hospitalization.Journal of the American Geriatrics Society · 2026Article
- Delirium in older adults in the emergency department: a scoping review of current research and identified knowledge gaps.BMC emergency medicine · 2026Article
- Progress of nursing management for delirium in critically ill geriatric patients: a narrative review.Frontiers in human neuroscience · 2026Review
- Epidemiology and assessments of delirium in nursing homes and rehabilitation facilities: a cross-country perspective.European geriatric medicine · 2025Article
- Pulling Back the Curtain on Hospital Dementia Detection: Validation of the Informant-Based Clinical Dementia Rating.Journal of the American Geriatrics Society · 2025Article
- Emergency Nurses' Perspectives on Adopting Geriatric Screenings for Cognitive Impairment: A Qualitative Study.Journal of emergency nursing · 2025Article
- Emergency Care for Persons Living with Dementia.Emergency medicine clinics of North America · 2025Review
- Delirium Prevention and Management in Older Adults in the Emergency Department.Emergency medicine clinics of North America · 2025Review
- Supportive Interventions Involving Family Carers of Patients With Delirium Superimposed on Dementia in Hospital: A Scoping Review.International journal of older people nursing · 2025Article
- The relationship between preoperative hypoalbuminemia and postoperative subsyndromal delirium in elderly hip fracture patients: a prospective study.Frontiers in medicine · 2025Article
- Implementation of delirium screening in the emergency department: A qualitative study with early adopters.Journal of the American Geriatrics Society · 2024Article
- A scoping review of geriatric emergency medicine research transparency in diversity, equity, and inclusion reporting.Journal of the American Geriatrics Society · 2024Article
- Enhancing healthcare access for an older population: The age-friendly emergency department.Journal of the American College of Emergency Physicians open · 2024Review
- A Lethal Combination of Delirium and Overcrowding in the Emergency Department.Journal of clinical medicine · 2023Review
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Authors and funding
6 authors.
Funding
Abstract
objectiveTo examine the ability of the family-rated Family Confusion Assessment Method (FAM-CAM) to identify delirium in the emergency department (ED) among patients with and without dementia, as compared to the reference-standard Confusion Assessment Method (CAM).
designValidation study.
settingUrban academic ED.
participantsDyads of ED patients, aged 70 years and older, and their family caregivers (N = 108 dyads). MEASUREMENTS: A trained reference standard interviewer performed a cognitive screen, delirium symptom assessment, and scored the CAM. The caregiver self-administered the FAM-CAM. Dementia was assessed using the Informant Questionnaire on Cognitive Decline in the Elderly and the medical record. For concurrent validity, performance of the FAM-CAM was compared to the CAM. For predictive validity, clinical outcomes (ED visits, hospitalization, and mortality) over 6 months were compared in FAM-CAM positive and negative patients, controlling for age, sex, comorbidity, and cognitive status.
resultsAmong the 108 patients, 30 (28%) were CAM positive for delirium and 58 (54%) presented with dementia. The FAM-CAM had a specificity of 83% and a negative predictive value of 83%. Most false negatives (n = 9 of 13, 69%) were due to caregivers not identifying the inattention criteria for delirium on the FAM-CAM. In patients with dementia, sensitivity was higher than in patients without (61% vs 43%). In adjusted models, a hospitalization in the following 6 months was more than three times as likely in FAM-CAM positive compared to negative patients (odds ratio = 3.4; 95% confidence interval = 1.2-9.3).
conclusionsAmong patients with and without dementia, the FAM-CAM shows qualities that are important in the ED setting for identification of delirium. Using the FAM-CAM as part of a systematic screening strategy for the ED, in which families' assessments could supplement healthcare professionals' assessments, is promising. J Am Geriatr Soc 68:983-990, 2020.
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