BACKGROUND: There is no valid instrument currently in use at acute-care hospitals in Hong Kong to aid the detection of cognitive impairment. The objectives of this study were to (1) validate the Digit Span Test (DST) in the identification and differentiation of dementia and delirium; and (2) determine the prevalence of major cognitive impairment in elderly people in an acute medical unit. METHODS: During the study period from January to February 2010, 144 patients aged 75 years or more who had had unplanned medical admissions were assessed by nurses, using the Digit Span Forwards (DSF) and the Digit Span Backwards (DSB) tests. The DST scores were compared with the psychiatrists' DSM-IV-based diagnoses. Receiver Operating Characteristics curve (ROC) was used in conjunction with sensitivity and specificity measures to assess the performance of DST. RESULTS: The prevalence rates of dementia alone, delirium alone and delirium superimposed on dementia were 21.5%, 9% and 9% respectively. The prior case-note documentation rate was 13.2% for dementia and 2.8% for delirium. Regarding the detection of major cognitive impairment, the ROC curve of DSB showed a sensitivity of 0.77 and specificity of 0.78 at the optimal cutoff of <3. A significant association between scores on the DST and the Cantonese version of the Mini-Mental State Examination (CMMSE) was found in this study (p < 0.05 for DSF, p = 0.00 for DSB). CONCLUSIONS: Dementia and delirium were prevalent, yet under-recognized, in acute medical geriatric inpatients. The DSB is an effective tool in identifying patients with major cognitive impairment.
BACKGROUND: There is no valid instrument currently in use at acute-care hospitals in Hong Kong to aid the detection of cognitive impairment. The objectives of this study were to (1) validate the Digit Span Test (DST) in the identification and differentiation of dementia and delirium; and (2) determine the prevalence of major cognitive impairment in elderly people in an acute medical unit. METHODS: During the study period from January to February 2010, 144 patients aged 75 years or more who had had unplanned medical admissions were assessed by nurses, using the Digit Span Forwards (DSF) and the Digit Span Backwards (DSB) tests. The DST scores were compared with the psychiatrists' DSM-IV-based diagnoses. Receiver Operating Characteristics curve (ROC) was used in conjunction with sensitivity and specificity measures to assess the performance of DST. RESULTS: The prevalence rates of dementia alone, delirium alone and delirium superimposed on dementia were 21.5%, 9% and 9% respectively. The prior case-note documentation rate was 13.2% for dementia and 2.8% for delirium. Regarding the detection of major cognitive impairment, the ROC curve of DSB showed a sensitivity of 0.77 and specificity of 0.78 at the optimal cutoff of <3. A significant association between scores on the DST and the Cantonese version of the Mini-Mental State Examination (CMMSE) was found in this study (p < 0.05 for DSF, p = 0.00 for DSB). CONCLUSIONS:Dementia and delirium were prevalent, yet under-recognized, in acute medical geriatric inpatients. The DSB is an effective tool in identifying patients with major cognitive impairment.
Authors: Hannah E Wadsworth; Kaltra Dhima; Kyle B Womack; John Hart; Myron F Weiner; Linda S Hynan; C Munro Cullum Journal: Arch Clin Neuropsychol Date: 2018-12-01 Impact factor: 2.813
Authors: Rainbow Tin Hung Ho; Jacob Kai Ki Cheung; Wai Chi Chan; Irene Kit Man Cheung; Linda Chiu Wah Lam Journal: BMC Geriatr Date: 2015-10-19 Impact factor: 3.921
Authors: Henrique C S Muela; Valeria A Costa-Hong; Mônica S Yassuda; Natália C Moraes; Claudia M Memória; Michel F Machado; Thiago A Macedo; Edson B S Shu; Ayrton R Massaro; Ricardo Nitrini; Alfredo J Mansur; Luiz A Bortolotto Journal: J Am Heart Assoc Date: 2017-01-11 Impact factor: 5.501
Authors: Nicola Filippini; Enikő Zsoldos; Rita Haapakoski; Claire E Sexton; Abda Mahmood; Charlotte L Allan; Anya Topiwala; Vyara Valkanova; Eric J Brunner; Martin J Shipley; Edward Auerbach; Steen Moeller; Kâmil Uğurbil; Junqian Xu; Essa Yacoub; Jesper Andersson; Janine Bijsterbosch; Stuart Clare; Ludovica Griffanti; Aaron T Hess; Mark Jenkinson; Karla L Miller; Gholamreza Salimi-Khorshidi; Stamatios N Sotiropoulos; Natalie L Voets; Stephen M Smith; John R Geddes; Archana Singh-Manoux; Clare E Mackay; Mika Kivimäki; Klaus P Ebmeier Journal: BMC Psychiatry Date: 2014-05-30 Impact factor: 3.630
Authors: Henrique C S Muela; Valeria A Costa-Hong; Mônica S Yassuda; Natália C Moraes; Claudia M Memória; Michel F Machado; Edson Bor-Seng-Shu; Ricardo C Nogueira; Alfredo J Mansur; Ayrton R Massaro; Ricardo Nitrini; Thiago A Macedo; Luiz A Bortolotto Journal: J Clin Hypertens (Greenwich) Date: 2017-11-05 Impact factor: 3.738