Motor Symptoms in 100 Patients With Delirium Versus Control Subjects: Comparison of Subtyping Methods

Meagher, David; Morán, María Teresa Cabero; Raju, Bangaru; Gibbons, Dympna; Donnelly, Sinéad; Saunders, Jean; Trzepacz, Paula T.

doi:10.1176/appi.psy.49.4.300

Cited by 97 publications

(100 citation statements)

References 43 publications

(33 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For patients scoring ≥4 on the 4-AT the motor subtype of delirium was determined using the Delirium Motor Subtype Scale (DMSS) [17]. The DMSS is a scale using 11 motor items derived from items used in previous motor subtyping methods but with relative specificity for delirium, which demonstrated correlation with objective measures of motor behavior, including electronic motion analysis.…”

Section: Methodsmentioning

confidence: 99%

A Point Prevalence Study of Delirium in Italian Nursing Homes

Morichi

Fedecostante

Morandi

et al. 2018

Dement Geriatr Cogn Disord

View full text Add to dashboard Cite

Background: Delirium is a common geriatric syndrome. Few studies have been conducted in nursing home (NH) residents. The aim of this project was to perform a point prevalence study of delirium in Italian NHs. Methods: Data collected in 71 NHs are presented. Inclusion criteria were age ≥65 years and native Italian speaker. Exclusion criteria were coma, aphasia, and end-of-life status. Sociodemographic and medical data were recorded. Delirium was assessed using the Assessment Test for Delirium and Cognitive Impairment (4-AT). Patients with a 4-AT score ≥4 were considered to have delirium. Motor subtype was evaluated using the Delirium Motor Subtype Scale (DMSS). Results: A total of 1,454 patients were evaluated (mean age 84.4 ± 7.4 years, 70.2% female), of whom 535 (36.8%) had delirium. In multivariate logistic regression analysis, variables significantly associated with delirium were education (OR 0.94, 95% CI 0.91–0.97), dementia (OR 3.12, 95% CI 2.38–4.09), functional dependence (OR 6.13, 95% CI 3.08–12.19 for ADL score 0; OR 1.99, 95% CI 1.03–3.84 for ADL score 1–5), malnutrition (OR 4.87, 95% CI 2.68–8.84), antipsychotics (OR 2.40, 95% CI 1.81–3.18), and physical restraints (OR 2.48, 95% CI 1.71–3.59). Conclusion: Delirium is common in older NH residents. Simple assessment tools might facilitate its recognition in this vulnerable population.

show abstract

Section: Methodsmentioning

confidence: 99%

A Point Prevalence Study of Delirium in Italian Nursing Homes

Morichi

Fedecostante

Morandi

et al. 2018

Dement Geriatr Cogn Disord

View full text Add to dashboard Cite

show abstract

“…Recently electronic motor analysis has also been used for motor subtyping [71] . Recently, Meagher et al [44] collated 30 clinical features used in different subtyping methods to define motor subtypes and developed a Delirium Motor Checklist (DMC). Next, they identified 11 items that by virtue of frequency, correlation with independent measures of motor behaviour and relative specificity for delirium were selected to comprise the Delirium Motor Subtype Scale (DMSS) [45] .…”

Section: Instruments For Assessment Of Motor Symptoms Of Deliriummentioning

confidence: 99%

“…DMC and delirium motor symptom scale [44,45] DMC is a checklist, which consists of 30 clinical features used in different subtyping methods to define motor subtypes. Of the 30 items, 11 items have been identified by virtue of frequency, correlation with independent measures of motor behaviour and relative specificity for delirium to comprise the DMSS which includes 11 items.…”

Section: Motor Subtyping By Liptzin Et Almentioning

confidence: 99%

Assessment scales for delirium: A review

Grover

Kate²

2012

WJP

146

128

View full text Add to dashboard Cite

Over the years many scales have been designed for screening, diagnosis and assessing the severity of delirium. In this paper we review the various instruments available to screen the patients for delirium, instruments available to diagnose delirium, assess the severity, cognitive functions, motoric subtypes, etiology and associated distress. Among the various screening instruments, NEECHAM confusion scale and delirium observation scale appear to be most suitable screening instrument for patients' in general medical and surgical wards, depending on the type of rater (physician or nurse). In general, the instruments which are used for diagnosis [i.e., confusion assessment method (CAM), CAM for intensive care unit (CAM-ICU), Delirium Rating Scale-revised version (DRS-R-98), memorial selirium assessment scale, etc. ] are based on various Diagnostic and Statistical Manual criteria and have good to excellent reliability and fair to good validity. Among the various diagnostic instruments, CAM is considered to be most useful instrument because of its accuracy, brevity, and ease of use by clinicians and lay interviewers. In contrast, DRS-R-98 appears to be a comprehensive instrument useful for diagnosis, severity rating and is sensitive to change and hence can be used for monitoring patients over a period. In the ICU setting, evidence suggests that CAM-ICU and Nursing Delirium Screening Scale had comparable sensitivities, but CAM-ICU has higher specificity. With regard to assessment of delirium in pediatric age group, certain instruments like Pediatric Anesthesia Emergence Delirium scale and pediatric CAM-ICU has been designed and have been found to be useful.

show abstract

“…Clinically defined subtypes can promote better understanding of delirium by allowing more targeted studies of pathophysiology and treatment [9]. Studies of delirium subtypes based on motor activity levels have found that patients with hyperactive phenomenology had shorter hospital stays and better outcomes than either mixed or hypoactive subtypes [7,10,11].…”

Section: Introductionmentioning

confidence: 99%

“…However, these studies are fraught with methodological inconsistencies, especially regarding motoric subtype definition. Concordance among four commonly used subtyping schemes was only 34% in a recent study where focus on 'pure' motor disturbances along with objective electronic motion analysis were identified as ways to develop methods with improved reliability and validity [9].…”

Section: Introductionmentioning

confidence: 99%