Delirium Bibliography

Reference Information

Title

Evaluation of the idea (identification and interventions for dementia in elderly Africans) brief cognitive screening tool for identification of delirium in older hospitalised adults in Tanzania

Authors

Paddick, S. M., Lewis, E. G., Duinmaijer, A. T., Banks, J., Urasa, S., Tucker, L., Kisoli, A., Cletus, J., Lissu, C., Kisima, J., Dotchin, C., Gray, W. K., Mushi, D., Walker, R.

Year

2016

Journal

Alzheimer's and Dementia

Abstract

Background: In sub-Saharan Africa, (SSA) there are no validated screening tools for delirium in older adults, despite the known vulnerability of this group to delirium and the associated adverse outcomes. The IDEA brief cognitive assessment has previously been validated for dementia and major cognitive impairment in low literacy settings in Tanzania and Nigeria. This study aims to assess the effectiveness of this brief assessment in identification of delirium in older hospitalised adults when compared to a widely validated assessment for delirium diagnosis, the confusion assessment method (CAM). Methods: Consecutive individuals aged 60 and over were screened on admission to medical wards of a tertiary referral hospital in Northern Tanzania using the IDEA brief cognitive assessment. All participants were subsequently assessed by a research doctor using the CAM alongside bedside cognitive assessment, neurological examination and informant history, blinded to the outcome of the IDEA cognitive assessment. Delirium was defined as a positive CAM score. Dementia and other diagnoses were defined according to DSM-V criteria. Interim. Results: 456 individuals were assessed using the CAM, of whom, 39 were unable to complete the cognitive screen due to reduced consciousness level or physical illness and were excluded. Complete data were therefore available for 417 individuals (43% female) of whom 20% were illiterate. Prevalence of delirium on admission was 62/417 and of major cognitive impairment (dementia or delirium) 98/417. The AUROC for delirium was 0.876 (95% CI 0.833-0.920) and 0.876 (95% CI 0.836-0.917) for major cognitive impairment. Conclusions: Provisional results indicate that the IDEA brief cognitive assessment was effective in screening for delirium in this setting. Data collection is ongoing, with follow up and confirmation of dementia diagnoses due to be completed in May 2016. Further analysis on completion of the study and evaluation of the IDEA brief cognitive assessment against DSM-V diagnosis of delirium by a specialist are awaited.

PMID

Keywords

adult
African
aged
clinical trial
cognitive defect
comparative effectiveness
consciousness level
controlled clinical trial
controlled study
diagnosis
DSM-5
female
follow up
human
information processing
major clinical study
male
middle aged
neurologic examination
prevalence
screening
single blind procedure
Tanzania
tertiary care center

Page(s)

P364-P365

Volume

12

Issue

7