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Lozano-Vicario L, Robles-Raya MJ, Del Val-Lafaja A, Cancio-Trujillo JM, Sánchez-García E, García-Meana J, Ferrara MC, Bellelli G, Gual N. [Multicenter cross-sectional study on the prevalence of delirium in orthogeriatric units: «DELFRA 24 study» protocol]. Rev Esp Geriatr Gerontol 2024; 59:101431. [PMID: 37918323 DOI: 10.1016/j.regg.2023.101431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/30/2023] [Accepted: 10/03/2023] [Indexed: 11/04/2023]
Abstract
INTRODUCTION Delirium is the most common perioperative complication in older adults with hip fracture (HF), leading to a catastrophic impact on their functional recovery and cognitive status. Currently, the true prevalence of this syndrome is unknown as its detection and management are not standardized in clinical practice. METHODS A multicenter observational cross-sectional study will be conducted nationwide, involving different orthogeriatric units in Spain. The prevalence of delirium will be assessed using the 4AT scale, along with its characteristics and its relationship with other geriatric syndromes, sociodemographic variables, surgical characteristics, and laboratory parameters. RESULTS Data collection is scheduled to take place on World Delirium Day (Wednesday, March 13, 2024), and therefore, the results are expected during the second or third quarter of 2024. CONCLUSIONS Understanding the real prevalence and characteristics of delirium in older adults with HF could contribute to the development of strategies for its detection and management, reducing the impact of its consequences.
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Affiliation(s)
- Lucía Lozano-Vicario
- Grupo de trabajo de Delirium de la Sociedad Española de Geriatría y Gerontología (SEGG); Servicio de Geriatría, Hospital Universitario de Navarra, Pamplona, Navarra, España.
| | - María José Robles-Raya
- Grupo de trabajo de Delirium de la Sociedad Española de Geriatría y Gerontología (SEGG); Servicio de Geriatría, Parc de Salut Mar, Barcelona, España
| | - Alodia Del Val-Lafaja
- Grupo de trabajo de Delirium de la Sociedad Española de Geriatría y Gerontología (SEGG); Servicio de Geriatría, Hospital Universitario Miguel Servet, Zaragoza, España
| | - José Manuel Cancio-Trujillo
- Grupo de trabajo de Delirium de la Sociedad Española de Geriatría y Gerontología (SEGG); Servicio de Geriatría y Cuidados Paliativos, Centro de Salud El Carme Badalona Servicios Asistenciales, Badalona, Barcelona, España
| | - Elisabet Sánchez-García
- Grupo de trabajo de Delirium de la Sociedad Española de Geriatría y Gerontología (SEGG); Servicio de Geriatría, Hospital Universitario Ramón y Cajal, Madrid, España
| | - Javier García-Meana
- Grupo de trabajo de Delirium de la Sociedad Española de Geriatría y Gerontología (SEGG); Unidad del Paciente Crónico Complejo, Hospital General Universitario Santa María del Rosell, Cartagena, Murcia, España
| | | | | | - Neus Gual
- Grupo de trabajo de Delirium de la Sociedad Española de Geriatría y Gerontología (SEGG); Parc Sanitari Pere Virgili, Barcelona, España; Universidad Autónoma de Barcelona, Barcelona, España
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Matsuda Y, Tanimukai H, Inoue S, Hirayama T, Kanno Y, Kitaura Y, Inada S, Sugano K, Yoshimura M, Harashima S, Wada S, Hasegawa T, Okamoto Y, Dotani C, Takeuchi M, Kako J, Sadahiro R, Kishi Y, Uchida M, Ogawa A, Inagaki M, Okuyama T. A revision of JPOS/JASCC clinical guidelines for delirium in adult cancer patients: a summary of recommendation statements. Jpn J Clin Oncol 2023; 53:808-822. [PMID: 37190819 DOI: 10.1093/jjco/hyad042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/26/2023] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVE The Japanese Psycho-Oncology Society and the Japanese Association of Supportive Care in Cancer have recently revised the clinical practice guidelines for delirium in adult cancer patients. This article reports the process of developing the revised guidelines and summarizes the recommendations made. METHODS The guidelines were developed in accordance with the Medical Information Network Distribution Service creation procedures. The guideline development group, consisting of multi-disciplinary members, created three new clinical questions: non-pharmacological intervention and antipsychotics for the prevention of delirium and trazodone for the management of delirium. In addition, systematic reviews of nine existing clinical questions have been updated. Two independent reviewers reviewed the proposed articles. The certainty of evidence and the strength of the recommendations were graded using the grading system developed by the Medical Information Network Distribution Service, following the concept of The Grading of Recommendations Assessment, Development, and Evaluation system. The modified Delphi method was used to validate the recommended statements. RESULTS This article provides a compendium of the recommendations along with their rationales, as well as a short summary. CONCLUSIONS These revised guidelines will be useful for the prevention, assessment and management of delirium in adult cancer patients in Japan.
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Affiliation(s)
- Yoshinobu Matsuda
- Department of Psychosomatic Internal Medicine, Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Hitoshi Tanimukai
- Faculty of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shinichiro Inoue
- Department of Neuropsychiatry, Okayama University Hospital, Dentistry, and Pharmaceutical Science, Okayama, Japan
| | - Takatoshi Hirayama
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yusuke Kanno
- Department of Home Health and Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuichi Kitaura
- Department of Psychiatry, Panasonic Health Insurance Organization Matsushita Memorial Hospital, Moriguchi, Japan
| | - Shuji Inada
- Department of Psychosomatic Medicine, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan
| | - Koji Sugano
- Division of Respiratory Medicine, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Masafumi Yoshimura
- Department of Occupational Therapy, Faculty of Rehabilitation, Kansai Medical University, Hirakata, Japan
| | - Saki Harashima
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Saho Wada
- Department of Neuropsychiatry, Nippon Medical School Tamanagayama Hospital, Tokyo, Japan
| | - Takaaki Hasegawa
- Center for Psycho-oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan
| | - Yoshiaki Okamoto
- Department of pharmacy, Ashiya Municipal Hospital, Ashiya, Japan
| | - Chikako Dotani
- Department of Pediatrics, The University of Tokyo Hospital, Tokyo, Japan
| | - Mari Takeuchi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Jun Kako
- College of Nursing Art and Science, University of Hyogo, Akashi, Japan
| | - Ryoichi Sadahiro
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yasuhiro Kishi
- Department of Psychiatry, Nippon Medical School Musashikosugi Hospital, Kawasaki, Japan
| | - Megumi Uchida
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Asao Ogawa
- Division of Psycho-Oncology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan
| | - Masatoshi Inagaki
- Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Toru Okuyama
- Department of Psychiatry/Palliative Care Center, Nagoya City University West Medical Center, Nagoya, Japan
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Lozano-Vicario L, Zambom-Ferraresi F, Zambom-Ferraresi F, de la Casa-Marín A, Ollo-Martínez I, Sáez de Asteasu ML, Cedeño-Veloz BA, Fernández-Irigoyen J, Santamaría E, Romero-Ortuno R, Izquierdo M, Martínez-Velilla N. Effectiveness of a multicomponent exercise training program for the management of delirium in hospitalized older adults using near-infrared spectroscopy as a biomarker of brain perfusion: Study protocol for a randomized controlled trial. Front Aging Neurosci 2022; 14:1013631. [PMID: 36589545 PMCID: PMC9797855 DOI: 10.3389/fnagi.2022.1013631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Delirium is an important cause of morbidity and mortality in older adults admitted to hospital. Multicomponent interventions targeting delirium risk factors, including physical exercise and mobilization, have been shown to reduce delirium incidence by 30-40% in acute care settings. However, little is known about its role in the evolution of delirium, once established. This study is a randomized clinical trial conducted in the Acute Geriatric Unit of Hospital Universitario de Navarra (Pamplona, Spain). Hospitalized patients with delirium who meet the inclusion criteria will be randomly assigned to the intervention or the control group. The intervention will consist of a multicomponent exercise training program, which will be composed of supervised progressive resistance and strength exercise over 3 consecutive days. Functional Near-Infrared Spectroscopy (NIRS) will be used for assessing cerebral and muscle tissue blood flow. The objective is to assess the effectiveness of this intervention in modifying the following primary outcomes: duration and severity of delirium and functional status. This study will contribute to determine the effectiveness of physical exercise in the management of delirium. It will be the first study to evaluate the impact of a multicomponent intervention based on physical exercise in the evolution of delirium. Clinical trial registration ClinicalTrials.gov. identifier: NCT05442892 (date of registration June 26, 2022).
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Affiliation(s)
- Lucía Lozano-Vicario
- Department of Geriatric Medicine, Hospital Universitario de Navarra (HUN), Pamplona, Spain,*Correspondence: Lucía Lozano-Vicario,
| | - Fabiola Zambom-Ferraresi
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Instituto de Investigación Sanitaria de Navarra (IdisNa), Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Fabricio Zambom-Ferraresi
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Instituto de Investigación Sanitaria de Navarra (IdisNa), Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Antón de la Casa-Marín
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Instituto de Investigación Sanitaria de Navarra (IdisNa), Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Iranzu Ollo-Martínez
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Instituto de Investigación Sanitaria de Navarra (IdisNa), Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Mikel L. Sáez de Asteasu
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Instituto de Investigación Sanitaria de Navarra (IdisNa), Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | | | - Joaquín Fernández-Irigoyen
- Clinical Neuroproteomics Unit, Navarrabiomed, Hospital Universitario de Navarra (HUN), Instituto de Investigación Sanitaria de Navarra (IdisNa), Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Enrique Santamaría
- Clinical Neuroproteomics Unit, Navarrabiomed, Hospital Universitario de Navarra (HUN), Instituto de Investigación Sanitaria de Navarra (IdisNa), Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | | | - Mikel Izquierdo
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Instituto de Investigación Sanitaria de Navarra (IdisNa), Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Nicolás Martínez-Velilla
- Department of Geriatric Medicine, Hospital Universitario de Navarra (HUN), Pamplona, Spain,Navarrabiomed, Hospital Universitario de Navarra (HUN), Instituto de Investigación Sanitaria de Navarra (IdisNa), Universidad Pública de Navarra (UPNA), Pamplona, Spain
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Pallotti MC, Lopez-Fidalgo J, Centeno C, Celin D, Biasco G, Giovannini M, Maltoni M, Noguera A. Does Delirium Phenomenology in Persons with Advanced Cancer Follow a Specific Pattern? J Palliat Med 2021; 24:1061-1066. [PMID: 33861630 DOI: 10.1089/jpm.2020.0473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: Recognizing delirium phenomenology (DP) aids the early diagnosis of this syndrome and improves quality of life in patients with advanced cancer. The aim of this study was to identify the neurobehavioral and cognitive patterns of delirium-related symptoms in persons with advanced cancer. Methods: We conducted an observational comparative prospective study on delirium in patients with advanced cancer in different palliative care settings, assessing the presentation/evolution of DP with the Memorial delirium assessment scale (MDAS). Results: Two hundred twenty-seven patients were enrolled on hospital/hospice admission. Of these, 57 were admitted with delirium, 170 without delirium, and 31 developed delirium during hospitalization. Of the 88 patients admitted with delirium or who developed it during hospitalization, only 32 underwent two consecutive MDAS evaluations (at diagnosis and after one week). Delirium resolved in 22 patients (first average MDAS score 10.08 vs. second 3.6 [p < 0.001]). Disorientation, short-term memory, and memory span were altered in all patients with unresolved delirium. The same features were altered in 18 (80%), 17 (80%), and 16 (70%) of the patients with resolved delirium, respectively, and in 58 (35%), 114 (67%), and 38 (23%) of no-delirium patients, respectively. Conclusion: Cognitive-related symptoms appear to be the most prevalent and earliest signs of DP in patients with advanced cancer.
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Affiliation(s)
- Maria Caterina Pallotti
- Seràgnoli Hospice Foundation, Bentivoglio, Italy.,Palliative Care Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Jesus Lopez-Fidalgo
- ATLANTES Research Programme, Institute for Culture and Society, University of Navarra, Pamplona, Spain
| | - Carlos Centeno
- ATLANTES Research Programme, Institute for Culture and Society, University of Navarra, Pamplona, Spain.,Institute de Investigacion Sanitaria de Navarra (IdiSNA), University of Navarra, Pamplona, Spain.,Clinica Universidad de Navarra, Institute of Culture and Society, University of Navarra, IdiSNA, Pamplona, Spain
| | | | - Guido Biasco
- Academy of Sciences of Palliative Medicine, Bentivoglio, Italy.,Department of Specialized, Experimental, and Diagnostic Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | | | - Marco Maltoni
- Palliative Care Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Antonio Noguera
- ATLANTES Research Programme, Institute for Culture and Society, University of Navarra, Pamplona, Spain.,Institute de Investigacion Sanitaria de Navarra (IdiSNA), University of Navarra, Pamplona, Spain.,Clinica Universidad de Navarra, Institute of Culture and Society, University of Navarra, IdiSNA, Pamplona, Spain
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Bush SH, Lawlor PG, Ryan K, Centeno C, Lucchesi M, Kanji S, Siddiqi N, Morandi A, Davis DHJ, Laurent M, Schofield N, Barallat E, Ripamonti CI. Delirium in adult cancer patients: ESMO Clinical Practice Guidelines. Ann Oncol 2018; 29:iv143-iv165. [PMID: 29992308 DOI: 10.1093/annonc/mdy147] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- S H Bush
- Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa
- Ottawa Hospital Research Institute, Ottawa
- Bruyère Research Institute, Ottawa
- Bruyère Continuing Care, Ottawa, Canada
| | - P G Lawlor
- Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa
- Ottawa Hospital Research Institute, Ottawa
- Bruyère Research Institute, Ottawa
- Bruyère Continuing Care, Ottawa, Canada
| | - K Ryan
- Department of Palliative Medicine, Mater Misericordiae University Hospital, Dublin
- St Francis Hospice, Dublin
- School of Medicine, University College, Dublin, Ireland
| | - C Centeno
- Department of Palliative Medicine, University of Navarra Hospital, Pamplona
- Palliative Medicine Group, Oncology Area, Navarra Institute for Health Research IdiSNA, Pamplona
- ATLANTES Research Program, Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain
| | - M Lucchesi
- Division of Thoracic Oncology, Cardio-Thoracic Department, University Hospital of Pisa, Pisa, Italy
| | - S Kanji
- Ottawa Hospital Research Institute, Ottawa
- Department of Pharmacy, The Ottawa Hospital, Ottawa, Canada
| | - N Siddiqi
- Department of Health Sciences, Hull York Medical School, University of York, York
- Bradford District Care NHS Foundation Trust, Bradford, UK
| | - A Morandi
- Department of Rehabilitation, Aged Care Unit, Ancelle Hospital, Cremona, Italy
| | - D H J Davis
- MRC Unit for Lifelong Health and Ageing at University College London, London, UK
| | - M Laurent
- Internal Medicine and Geriatric Department, APHP, Henri-Mondor Hospital, Créteil
- University Paris Est (UPE), UPEC A-TVB DHU, CEpiA (Clinical Epidemiology and Aging) Unit EA 7376, Créteil, France
| | | | - E Barallat
- Faculty of Nursing, Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
| | - C I Ripamonti
- Department of Onco-Haematology Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano, Italy
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Barahona E, Pinhao R, Galindo V, Noguera A. The Diagnostic Sensitivity of the Memorial Delirium Assessment Scale-Spanish Version. J Pain Symptom Manage 2018; 55:968-972. [PMID: 29155289 DOI: 10.1016/j.jpainsymman.2017.11.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 11/01/2017] [Accepted: 11/05/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Although Memorial Delirium Assessment Scale (MDAS) is a successful tool for delirium evaluation and monitoring, it is nevertheless important to determine whether cutoff scores vary according to the studied population. The main objective of this study was to evaluate the diagnostic sensitivity of the recently validated Spanish version of the MDAS. The secondary objective was to analyze possible diagnostic differences when used in a hospice or general hospital setting. METHODOLOGY A prospective study was conducted with advanced cancer patients in two settings (hospice and general hospital). A diagnosis of delirium was established according to clinical criteria and the Confusion Assessment Method. Sensitivity (S), specificity (Sp), positive predictive value, and negative predictive value were determined according to the receiver operating characteristics curve. The MDAS values for different centers were studied using nonparametric tests (Mann-Whitney). RESULTS A total of 67 patients were included, 28 of whom had been diagnosed with delirium (15/40 hospice and 13/27 general hospital). The mean MDAS scores were 13.6 and 5.5 for the delirium and nondelirium groups, respectively. A cutoff score of 7 gave the optimal screening diagnosis balance (S 92.6%, Sp 71.8%, positive predictive value 70.1%, and negative predictive value 93.3%). Diagnoses of anxiety and depression were not related with delirium (P ≤ 0.44). A diagnosis of dementia was related to delirium (P ≤ 0.052) but did not influence the diagnostic sensitivity of MDAS (P ≤ 0.26). No differences were found between hospice and general hospital settings as regards the diagnostic sensitivity of MDAS. CONCLUSION A screening cutoff of 7 appears to be optimal for MDAS Spanish version. No differences were found between advanced cancer patients cared for in a hospice or general hospital. However, more research is required to define the MDAS cutoff for patients with advanced cancer and dementia.
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Affiliation(s)
- Elena Barahona
- Primary Healthcare Centre Buenos Aires, Madrid, Spain; Primary Healthcare, Madrid, Spain; Palliative Care Unit, Fundación Jiménez Díaz, Madrid, Spain; Palliative Care Support Team, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
| | - Rita Pinhao
- Primary Healthcare Centre Buenos Aires, Madrid, Spain; Primary Healthcare, Madrid, Spain; Palliative Care Unit, Fundación Jiménez Díaz, Madrid, Spain; Palliative Care Support Team, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
| | - Victoria Galindo
- Primary Healthcare Centre Buenos Aires, Madrid, Spain; Primary Healthcare, Madrid, Spain; Palliative Care Unit, Fundación Jiménez Díaz, Madrid, Spain; Palliative Care Support Team, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
| | - Antonio Noguera
- Primary Healthcare Centre Buenos Aires, Madrid, Spain; Primary Healthcare, Madrid, Spain; Palliative Care Unit, Fundación Jiménez Díaz, Madrid, Spain; Palliative Care Support Team, Clínica Universidad de Navarra, Pamplona, Navarra, Spain.
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7
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Isenberg-Grzeda E, Huband H, Lam H. A review of cognitive screening tools in cancer. Curr Opin Support Palliat Care 2018; 11:24-31. [PMID: 28009651 DOI: 10.1097/spc.0000000000000257] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW Cancer-related cognitive impairment (CRCI) is highly prevalent, and assessment of cognition is crucial in providing optimal cancer care. Neuropsychological assessment (NPA) can be lengthy and expensive. Cognitive screening tools are plenty but validity has not been thoroughly studied for use in cancer patients. RECENT FINDINGS Our search of the recent literature revealed that the Montreal Cognitive Assessment, Mini-Mental State Examination, and Clock Draw Test were the most frequently studied objective screening tools. The Functional Assessment of Cancer Therapy-Cognitive Function and the Cognitive Symptom Checklist-Work 21 were the most commonly studied subjective measures of perceived cognitive impairment. Evidence supports using the Montreal Cognitive Assessment or the Clock Draw Test over the Mini-Mental State Examination to screen for cognitive impairment within specific patient populations. In addition, adding a subjective measure of cognitive impairment (e.g., Functional Assessment of Cancer Therapy-Cognitive Function) may increase diagnostic sensitivity. SUMMARY These suggest that cognitive screening tools may have a role in screening for CRCI, particularly when full NPA is not feasible. Researchers must continue to conduct high-quality studies to build an evidence to guide best practices in screening for CRCI.
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Affiliation(s)
- Elie Isenberg-Grzeda
- aDepartment of Psychiatry, University of Toronto bOdette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario cDalhousie University, Halifax, Nova Scotia dLibrary Services, Sunnybrook Health Sciences Centre, Toronto, Ontario
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Shi Z, Wu Y, Li C, Fu S, Li G, Zhu Y, Swain CA, Marcantonio ER, Xie Z, Shen Y. Using the Chinese version of Memorial Delirium Assessment Scale to describe postoperative delirium after hip surgery. Front Aging Neurosci 2014; 6:297. [PMID: 25414664 PMCID: PMC4220661 DOI: 10.3389/fnagi.2014.00297] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 10/11/2014] [Indexed: 02/05/2023] Open
Abstract
Objective: Memorial Delirium Assessment Scale (MDAS) assesses severity of delirium. However, whether the MDAS can be used in a Chinese population is unknown. Moreover, the optimal postoperative MDAS cutoff point for describing postoperative delirium in Chinese remains largely to be determined. We therefore performed a pilot study to validate MDAS in the Chinese language and to determine the optimal postoperative MDAS cutoff point for delirium. Methods: Eighty-two patients (80 ± 6 years, 21.9% male), who had hip surgery under general anesthesia, were enrolled. The Confusion Assessment Method (CAM) and Mini-Mental State Examination (MMSE) were administered to the patients before surgery. The CAM and MDAS were performed on the patients on the first, second and fourth postoperative days. The reliability and validity of the MDAS were determined. A receiver operating characteristic (ROC) curve was used to determine the optimal Chinese version MDAS cutoff point for the identification of delirium. Results: The Chinese version of the MDAS had satisfactory internal consistency (α = 0.910). ROC analysis obtained an average optimal MDAS cutoff point of 7.5 in describing the CAM-defined postoperative delirium, with an area under the ROC of 0.990 (95% CI 0.977–1.000, P < 0.001). Conclusions: The Chinese version of the MDAS had good reliability and validity. The patients whose postoperative Chinese version MDAS cutoff point score was 7.5 would likely have postoperative delirium. These results have established a system for a larger scale study in the future.
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Affiliation(s)
- Zhongyong Shi
- Department of Psychiatry, Tenth People's Hospital of Tongji University Shanghai, China ; Department of Anesthesiology, Tenth People's Hospital of Tongji University Shanghai, China
| | - Yujie Wu
- Department of Psychiatry, Tenth People's Hospital of Tongji University Shanghai, China ; Department of Anesthesiology, Tenth People's Hospital of Tongji University Shanghai, China
| | - Cheng Li
- Department of Anesthesiology, Tenth People's Hospital of Tongji University Shanghai, China
| | - Shukun Fu
- Department of Anesthesiology, Tenth People's Hospital of Tongji University Shanghai, China
| | - Guodong Li
- Department of Orthopedic Surgery, Tenth People's Hospital of Tongji University Shanghai, China
| | - Yingbo Zhu
- School of Medicine, Tongji University Shanghai, China
| | - Celeste A Swain
- Geriatric Anesthesia Research Unit, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School Charlestown, MA, USA
| | - Edward R Marcantonio
- Divisions of General Medicine and Primary Care and Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School Boston, MA, USA
| | - Zhongcong Xie
- Geriatric Anesthesia Research Unit, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School Charlestown, MA, USA
| | - Yuan Shen
- Department of Psychiatry, Tenth People's Hospital of Tongji University Shanghai, China
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