International psychogeriatrics
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In this prospective cohort of 71 elderly patients undergoing cardiac surgery, each subject was interviewed before and after surgery to detect incident delirium using the Confusion Assessment Method (CAM), the Mini-Mental State Examination (MMSE), the Clock Test, and a health record review. The first 41 were assessed by a physician and the remaining 30 by two study nurses. Delirium was then diagnosed by a physician using DSM-III-R criteria. ⋯ When standard cutoffs were used, neither the MMSE nor the Clock Test were found to be sensitive markers for delirium (.30 and .09, respectively). Recognition of delirium by charting was superior in nurses compared to physicians (.83 vs. .30). We conclude that the sensitivity of markers for delirium, such as the CAM and health record documentation, is dependent on the training background of the operator.
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Comparative Study
Some methodological issues in using aggression rating scales in intervention studies among institutionalized elderly.
Aggressive behavior among geriatric psychiatry inpatients spontaneously declines during serial measurements over time with rating scales. ⋯ A "run in" period of at least 4 weeks may be needed in intervention studies using the SOAS to reduce contamination by spontaneous decline.