OBJECTIVES: Delirium is very frequent in older patients presenting to the emergency department (ED), but is often undetected. The purpose of this study was to evaluate the performance of the French version of the 4 A’s Test (4AT-F) for the detection of delirium and cognitive impairment in older patients. METHODS: The study was conducted in four Canadian ED. Participants (n= 320) were independent or semi-independent patients (able to perform ≥5 activities of daily living) aged 65 and older and had an 8-hour exposure to the ED environment. The Telephone Interview for Cognitive Status (TICS-m), the Confusion Assessment Method (CAM) as well as the 4AT-F were administered to patients at the initial interview. The CAM and 4AT-F were then administered twice a day during the patients’ ED or hospital stay. The 4AT-F’s sensitivity and specificity were compared to those of the CAM (for delirium), and to that of the TICS (for cognitive impairment). RESULTS: Our results suggest that the 4AT-F has a sensitivity of 84% (95% CI: [76, 93]) and a specificity of 74% (95% CI: [70, 78]) for delirium, as well as a sensitivity of 49% (95% CI: [34, 64]) and a specificity of 87% (95% CI: [82, 92]) for cognitive impairment. CONCLUSION: The 4AT-F is a fast and reliable screening tool for delirium and cognitive impairment in ED. Due to its quick administration time, it allows a systematic screening of patients at risk of delirium, without significantly increasing the workload of the ED staff.
OBJECTIVES:Delirium is very frequent in older patients presenting to the emergency department (ED), but is often undetected. The purpose of this study was to evaluate the performance of the French version of the 4 A’s Test (4AT-F) for the detection of delirium and cognitive impairment in older patients. METHODS: The study was conducted in four Canadian ED. Participants (n= 320) were independent or semi-independent patients (able to perform ≥5 activities of daily living) aged 65 and older and had an 8-hour exposure to the ED environment. The Telephone Interview for Cognitive Status (TICS-m), the Confusion Assessment Method (CAM) as well as the 4AT-F were administered to patients at the initial interview. The CAM and 4AT-F were then administered twice a day during the patients’ ED or hospital stay. The 4AT-F’s sensitivity and specificity were compared to those of the CAM (for delirium), and to that of the TICS (for cognitive impairment). RESULTS: Our results suggest that the 4AT-F has a sensitivity of 84% (95% CI: [76, 93]) and a specificity of 74% (95% CI: [70, 78]) for delirium, as well as a sensitivity of 49% (95% CI: [34, 64]) and a specificity of 87% (95% CI: [82, 92]) for cognitive impairment. CONCLUSION: The 4AT-F is a fast and reliable screening tool for delirium and cognitive impairment in ED. Due to its quick administration time, it allows a systematic screening of patients at risk of delirium, without significantly increasing the workload of the ED staff.
Authors: Zoë Tieges; Alasdair M J Maclullich; Atul Anand; Claire Brookes; Marica Cassarino; Margaret O'connor; Damien Ryan; Thomas Saller; Rakesh C Arora; Yue Chang; Kathryn Agarwal; George Taffet; Terence Quinn; Susan D Shenkin; Rose Galvin Journal: Age Ageing Date: 2020-11-11 Impact factor: 10.668
Authors: Christopher R Carpenter; Nada Hammouda; Elizabeth A Linton; Michelle Doering; Ugochi K Ohuabunwa; Kelly J Ko; William W Hung; Manish N Shah; Lee A Lindquist; Kevin Biese; Daniel Wei; Libby Hoy; Lori Nerbonne; Ula Hwang; Scott M Dresden Journal: Acad Emerg Med Date: 2020-12-12 Impact factor: 5.221
Authors: Zoë Tieges; Alasdair M J Maclullich; Atul Anand; Claire Brookes; Marica Cassarino; Margaret O'connor; Damien Ryan; Thomas Saller; Rakesh C Arora; Yue Chang; Kathryn Agarwal; George Taffet; Terence Quinn; Susan D Shenkin; Rose Galvin Journal: Age Ageing Date: 2021-05-05 Impact factor: 10.668
Authors: Honoria Ocagli; Daniele Bottigliengo; Giulia Lorenzoni; Danila Azzolina; Aslihan S Acar; Silvia Sorgato; Lucia Stivanello; Mario Degan; Dario Gregori Journal: Int J Environ Res Public Health Date: 2021-07-02 Impact factor: 3.390
Authors: Agneta H Calf; Maaike A Pouw; Barbara C van Munster; Johannes G M Burgerhof; Sophia E de Rooij; Nynke Smidt Journal: Age Ageing Date: 2021-01-08 Impact factor: 10.668