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Abstract
BackgroundDelirium is a frequent psychopathological syndrome in geriatric patients. It is sometimes the only symptom of acute illness and bears a high risk for complications. Therefore, feasible assessments are needed for delirium detection.Objective and methodsRapid review of available delirium assessments based on a current Medline search and cross-reference check with a special focus on those implemented in acute care hospital settings.ResultsA total of 75 delirium detection tools were identified. Many focused on inattention as well as acute onset and/or fluctuating course of cognitive changes as key features for delirium. A range of assessments are based on the confusion assessment method (CAM) that has been adapted for various clinical settings. The need for a collateral history, time resources and staff training are major challenges in delirium assessment. Latest tests address these through a two-step approach, such as the ultrabrief (UB) CAM or by optional assessment of temporal aspects of cognitive changes (4 As test, 4AT). Most delirium screening assessments are validated for patient interviews, some are suitable for monitoring delirium symptoms over time or diagnosing delirium based on collateral history only.ConclusionBesides the CAM the 4AT has become well-established in acute care because of its good psychometric properties and practicability. There are several other instruments extending and improving the possibilities of delirium detection in different clinical settings.Supplementary InformationThe online version of this article (10.1007/s00391-021-02003-5) contains supplementary material, which is available to authorized users.
Highlights
Delirium is a frequent psychopathological and cognitive syndrome in geriatric patients and is associated with a high risk of acute care complications and negative outcomes [37]
A total of 75 delirium assessments were identified of which a selection of 15 tools with high clinical practicability and satisfactory psychometric properties are presented (
A total of 13 tools belonging to the confusion assessment method (CAM) family were identified, all focusing on the 4 core symptoms: acute onset and/or fluc
Summary
Delirium is a frequent psychopathological and cognitive syndrome in geriatric patients and is associated with a high risk of acute care complications and negative outcomes [37]. It is the most important presenting phenotype of acute encephalopathy [61]. Delirium is a frequent psychopathological syndrome in geriatric patients It is sometimes the only symptom of acute illness and bears a high risk for complications. The need for a collateral history, time resources and staff training are major challenges in delirium assessment Latest tests address these through a two-step approach, such as the ultrabrief (UB) CAM or by optional assessment of temporal aspects of cognitive changes (4 As test, 4AT). For the adequate administration of preventive measures and treatment early identification of patients at high risk for and with delirium is essential; presentation of delirium can be heterogeneous and identification challenging
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