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Boris Andorra, Alexandre Boussuge, Thomas Gilbert

    Geriatrie Et Psychologie Neuropsychiatrie Du Vieillissement
    |June 2, 2022
    PubMed
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    Delirium, a common condition in hospitalized older adults, is often underdiagnosed. This review highlights tools for early detection, including rapid options like the 4AT, 3D-CAM, and UB-CAM, to improve patient outcomes.

    Area of Science:

    • Geriatric Medicine
    • Psychiatry
    • Clinical Diagnostics

    Background:

    • Delirium is highly prevalent in hospitalized elderly patients, leading to severe clinical consequences.
    • Despite its frequency, delirium remains significantly underdiagnosed in clinical settings.
    • Early identification of delirium is crucial for optimizing management and reducing complications.

    Purpose of the Study:

    • To review and describe the performance and utility of commonly used delirium identification tools.
    • To focus on tools suitable for rapid assessment, specifically those taking under 3 minutes to administer.
    • To evaluate their potential for clinical practice and research.

    Main Methods:

    • A narrative review of existing literature on delirium screening and diagnostic tools.

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  • Identification of tools frequently used in clinical practice and research.
  • Categorization of tools based on administration time, with a focus on rapid assessment instruments.

    • Main Results:

    • Four internationally validated tools (CAM, DRS-R-98, DOSS, MDAS) are commonly used, with French versions available for three; their administration time ranges from 5 to 30 minutes.
    • Rapid assessment tools, including the 4AT, 3D-CAM, and UB-CAM, demonstrate promising diagnostic performance despite having a more limited evidence base.
    • These faster tools offer potential for widespread implementation due to their efficiency.

    Conclusions:

    • Validated, easy-to-use, and rapid tools are necessary for effective delirium identification in hospitalized older adults.
    • The 4AT, 3D-CAM, and UB-CAM show particular promise for early delirium detection.
    • Further research is needed to validate these rapid tools in French and clarify their clinical impact.