OBJECTIVES: To evaluate the impact of using different diagnostic criteria on prevalence rates of delirium and subsyndromal delirium (SSD) among demented long-term care (LTC) residents. DESIGN: Descriptive study. SETTING: LTC settings in Quebec City, Canada. PARTICIPANTS: Participants were 155 individuals aged 65 and older, with dementia. MEASUREMENTS: (1) Prevalence rates of delirium according to: (a) the Diagnostic and Statistical Manual of Mental Disorders (DSM-III, DSM-III-R, and DSM-IV) and (b) the Confusion Assessment Method (CAM) algorithms for definite and probable delirium; and (2) prevalence rates of SSD employing 2 definitions described in previous studies. RESULTS: Prevalence rates of delirium according to each set of criteria were 26.5% for DSM-III; 29% for DSM-IV-TR; 41.3% for DSM-III-R; 45.8% for CAM algorithm for definite delirium; and 70.3% for CAM algorithm for probable delirium. A total of 109 subjects (70.3%) were identified as delirious consistent with at least one classification and 37 (23.9%) met all the sets of criteria considered. Prevalence rates for SSD were 75 (48.4%) and 78 (50.3%) depending on the definition employed. CONCLUSION: Prevalence rates for delirium are much affected by the diagnostic formulations used. The use of DSM-IV-TR among this population could result in fewer cases being identified as delirious and thus compromise proper care for those individuals. Considering that SSD was prevalent among this population, a systematic implementation of protocols targeting risk factors of delirium might be beneficial among demented LTC residents.
OBJECTIVES: To evaluate the impact of using different diagnostic criteria on prevalence rates of delirium and subsyndromal delirium (SSD) among demented long-term care (LTC) residents. DESIGN: Descriptive study. SETTING: LTC settings in Quebec City, Canada. PARTICIPANTS: Participants were 155 individuals aged 65 and older, with dementia. MEASUREMENTS: (1) Prevalence rates of delirium according to: (a) the Diagnostic and Statistical Manual of Mental Disorders (DSM-III, DSM-III-R, and DSM-IV) and (b) the Confusion Assessment Method (CAM) algorithms for definite and probable delirium; and (2) prevalence rates of SSD employing 2 definitions described in previous studies. RESULTS: Prevalence rates of delirium according to each set of criteria were 26.5% for DSM-III; 29% for DSM-IV-TR; 41.3% for DSM-III-R; 45.8% for CAM algorithm for definite delirium; and 70.3% for CAM algorithm for probable delirium. A total of 109 subjects (70.3%) were identified as delirious consistent with at least one classification and 37 (23.9%) met all the sets of criteria considered. Prevalence rates for SSD were 75 (48.4%) and 78 (50.3%) depending on the definition employed. CONCLUSION: Prevalence rates for delirium are much affected by the diagnostic formulations used. The use of DSM-IV-TR among this population could result in fewer cases being identified as delirious and thus compromise proper care for those individuals. Considering that SSD was prevalent among this population, a systematic implementation of protocols targeting risk factors of delirium might be beneficial among demented LTC residents.
Authors: Nikki L Hill; Ann M Kolanowski; Donna Fick; Vernon M Chinchilli; Rita A Jablonski Journal: Res Gerontol Nurs Date: 2014-03-18 Impact factor: 1.571
Authors: Nathan E Brummel; Leanne M Boehm; Timothy D Girard; Pratik P Pandharipande; James C Jackson; Christopher G Hughes; Mayur B Patel; Jin H Han; Eduard E Vasilevskis; Jennifer L Thompson; Rameela Chandrasekhar; Gordon R Bernard; Robert S Dittus; E Wesley Ely Journal: Am J Crit Care Date: 2017-11 Impact factor: 2.228
Authors: Margaret R Puelle; Cyrus M Kosar; Guoquan Xu; Eva Schmitt; Richard N Jones; Edward R Marcantonio; Zara Cooper; Sharon K Inouye; Jane S Saczynski Journal: J Gerontol Nurs Date: 2015-08 Impact factor: 1.254
Authors: Frederick E Sieber; Khwaji J Zakriya; Allan Gottschalk; Mary-Rita Blute; Hochang B Lee; Paul B Rosenberg; Simon C Mears Journal: Mayo Clin Proc Date: 2010-01 Impact factor: 7.616
Authors: Ann M Kolanowski; Donna M Fick; Mark S Litaker; Linda Clare; Doug Leslie; Malaz Boustani Journal: Trials Date: 2011-05-11 Impact factor: 2.279