General hospital psychiatry
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Gen Hosp Psychiatry · Jan 2001
Comparative StudyClinical utility and validation of the Japanese version of Memorial Delirium Assessment Scale in a psychogeriatric inpatient setting.
Delirium is a common mental disorder in the elderly. The Memorial Delirium Assessment Scale (MDAS) was developed in 1997 to assess delirium severity over time. The purpose of the current prospective study is to assess the clinical utility, diagnostic potential, reliability and validity of the Japanese version of MDAS in a psychogeriatric unit setting. ⋯ High levels of consistency within raters (Cronbach's alpha=0.92) and reliability between raters (0.98) were indicated. The correlation between MDAS scores and rating on the Delirium Rating Scale (r=.74, P=.0011), the Clinician's Global Rating of delirium severity (r=.67, P=.0047), and the Mini Mental State Examination (r=-.54, P=.029) was fair. The MDAS seems to be a reliable measuring instrument for assessing delirium in elderly patients.
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Gen Hosp Psychiatry · Jan 2001
Evaluation of the Confusion Assessment Method (CAM) as a screening tool for delirium in the emergency room.
The objective of this study was to compare the results of the Confusion Assessment Method (CAM) obtained by a trained non-physician interviewer to those obtained by a geriatrician, among a sample of elderly patients seen in an emergency room. A group of 110 elderly patients (> or =66 years) were evaluated in the emergency room by a lay interviewer. The geriatrician conducted an interview in the presence of the lay interviewer. ⋯ In conclusion, the CAM used by a trained lay interviewer in the emergency room is sensitive, specific, reliable and easy to use for the identification of patients with delirium. The under-recognition and under-treatment of delirium is a major health issue and has important clinical and financial implications. The implementation of systematic screening in populations at risk could increase the rate of early detection and lead to the appropriate management of delirious patients.