MMSE items that predict incident delirium and hypoactive subtype in older medical inpatients

Abstract Because hypoactive delirium is especially under-recognized, we analyzed which Mini-Mental State Examination (MMSE) items predicted incident delirium and its hypoactive motor presentation. Over a 1-year period, older medical inpatients ( n =291) were consecutively screened on admission with...

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Bibliographic Details
Published in:Psychiatry research 2014-12, Vol.220 (3), p.975-981
Main Authors: Gabriel Franco, José, Santesteban, Olga, Trzepacz, Paula, Bernal, Carolina, Valencia, Camila, Ocampo, María Victoria, Pablo, Joan de, Gaviria, Ana Milena, Vilella, Elisabet
Format: Article
Language:English
Subjects:
Adult and adolescent clinical studies
Aged
Aged, 80 and over
Biological and medical sciences
Brief Psychiatric Rating Scale - standards
Case-Control Studies
Cognitive impairment
Cohort Studies
Delirium
Delirium - diagnosis
Delirium - psychology
Dementia
Elderly
Female
Geriatric Assessment - methods
Humans
Incidence
Inpatients - psychology
Longitudinal Studies
Male
Medical sciences
Middle Aged
Mini Mental State Exam
Organic mental disorders. Neuropsychology
Predictive Value of Tests
Prospective Studies
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Risk Factors
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Summary:Abstract Because hypoactive delirium is especially under-recognized, we analyzed which Mini-Mental State Examination (MMSE) items predicted incident delirium and its hypoactive motor presentation. Over a 1-year period, older medical inpatients ( n =291) were consecutively screened on admission with the Confusion Assessment Method-Spanish (CAM-S) to exclude prevalent delirium. Nondelirious patients were evaluated the same day with the MMSE, followed by daily ratings with the CAM-S. Those who became CAM-S positive were rated using the Delirium Rating Scale—Revised-98 to assess severity and motor subtype. Disorientation to time (OR 4.4, 95% CI 1.7–11.1) and place (OR 3.8, 95% CI 1.7–8.2) at admission were risk factors for delirium at follow-up and together correctly classified 88.3% of subjects as to delirium status. Disorientation to time and place, and visuoconstructional impairment were each associated with either hypoactive or mixed subtype ( p
ISSN:0165-1781
1872-7123
DOI:10.1016/j.psychres.2014.09.003