Abstract
Delirium is very frequent in older patients presenting to the emergency department (ED), but is often undetected. The purpose of this study was to evaluate the performance of the French version of the 4 A’s Test (4AT-F) for the detection of delirium and cognitive impairment in older patients. The study was conducted in four Canadian ED. Participants (n= 320) were independent or semi-independent patients (able to perform ≥5 activities of daily living) aged 65 and older and had an 8-hour exposure to the ED environment. The Telephone Interview for Cognitive Status (TICS-m), the Confusion Assessment Method (CAM) as well as the 4AT-F were administered to patients at the initial interview. The CAM and 4AT-F were then administered twice a day during the patients’ ED or hospital stay. The 4AT-F’s sensitivity and specificity were compared to those of the CAM (for delirium), and to that of the TICS (for cognitive impairment). Our results suggest that the 4AT-F has a sensitivity of 84% (95% CI: [76, 93]) and a specificity of 74% (95% CI: [70, 78]) for delirium, as well as a sensitivity of 49% (95% CI: [34, 64]) and a specificity of 87% (95% CI: [82, 92]) for cognitive impairment. The 4AT-F is a fast and reliable screening tool for deliriu...Continue Reading
References
Dec 15, 1990·Annals of Internal Medicine·S K InouyeR I Horwitz
Jan 1, 1987·Journal of Chronic Diseases·M E CharlsonC R MacKenzie
Oct 1, 1985·Critical Care Medicine·W A KnausJ E Zimmerman
Oct 20, 1999·Journal of Clinical Epidemiology·J McCuskerE Belzile
Feb 28, 2001·General Hospital Psychiatry·J MonetteM Afilalo
Apr 4, 2003·International Journal of Geriatric Psychiatry·Celeste A de JagerRobert Clarke
Nov 7, 2009·Neuroepidemiology·David S KnopmanWalter A Rocca
Apr 7, 2010·Annals of Emergency Medicine·Jin H HanE Wesley Ely
Oct 25, 2012·Radiology·Tessa S S GendersM G Myriam Hunink
Aug 7, 2013·Annals of Emergency Medicine·Jin H HanE Wesley Ely
Aug 31, 2013·Stroke; a Journal of Cerebral Circulation·Rosalind LeesTerence J Quinn
Nov 28, 2013·Age and Ageing·Susan D ShenkinAlasdair M J MacLullich
Feb 27, 2014·Journal of Neurology, Neurosurgery, and Psychiatry·Niamh A O'ReganSuzanne Timmons
Mar 5, 2014·Age and Ageing·Giuseppe BellelliAlasdair M J MacLullich
Mar 29, 2014·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Jin H HanE Wesley Ely
Apr 22, 2014·Annals of Emergency Medicine·UNKNOWN American College of Emergency PhysiciansUNKNOWN Geriatric Emergency Department Guidelines Task Force
Oct 21, 2014·Annals of Internal Medicine·Edward R MarcantonioSharon K Inouye
Oct 30, 2014·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Jin H HanE Wesley Ely
Mar 12, 2016·Neuropsychiatric Disease and Treatment·Sanchai Kuladee, Thanavadee Prachason
Mar 24, 2016·International Psychogeriatrics·Philippe VoyerAnnick Bédard
May 11, 2016·Journal of the American Geriatrics Society·Mario BoGiuseppe Bellelli
May 31, 2016·Alzheimer's & Dementia : Diagnosis, Assessment & Disease Monitoring·Sally J VogelJustin B Miller
Apr 12, 2017·Canadian Geriatrics Journal : CGJ·Marcel ÉmondJacques S Lee
Oct 7, 2017·Age and Ageing·Dawn O'SullivanSuzanne Timmons
Citations
Oct 4, 2020·Age and Ageing·Agneta H CalfNynke Smidt
Nov 30, 2018·CJEM·Debra Eagles
Dec 10, 2019·Age and Ageing·Radcliffe LiskThang S Han
Oct 21, 2020·International Journal of Environmental Research and Public Health·Eunhye JeongJuneyoung Lee
Nov 17, 2020·Age and Ageing·Zoë TiegesRose Galvin
Nov 3, 2020·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Christopher R CarpenterUNKNOWN GEAR Network
Dec 29, 2020·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Thang S HanChristopher H Fry
Feb 23, 2021·Annals of Emergency Medicine·Rachel E BridwellBrit Long
Apr 5, 2021·European Geriatric Medicine·Sigurd EvensenIngvild Saltvedt
Apr 18, 2021·Emergency Medicine Clinics of North America·Phillip D Magidson, Christopher R Carpenter
May 6, 2021·Age and Ageing·Zoë TiegesRose Galvin
Jun 17, 2021·Philosophy, Ethics, and Humanities in Medicine : PEHM·Guillaume SaccoCédric Annweiler
Jul 11, 2021·The Journal of Thoracic and Cardiovascular Surgery·Yue ChangRakesh C Arora
Oct 10, 2021·European Geriatric Medicine·Marius MyrstadMarit Stordal Bakken