Screening for Delirium Using Family Caregivers: Convergent Validity of the Family Confusion Assessment Method and Interviewer-Rated Confusion Assessment Method

• Autores: Melinda R. Steis, Lois Evans, Karen B. Hirschman, Alexandra L. Hanlon, Donna M. Fick, Nina Flanagan, Sharon K. Inouye
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 60, Nº. 11, 2012, págs. 2121-2126
• Idioma: inglés
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• Resumen

  • Objectives: To explore agreement between the Family Confusion Assessment Method (FAM-CAM) for delirium identification and interviewer-rated CAM delirium ratings.

    Design: Exploratory analysis of agreement.

    Setting: Community.

    Participants: Fifty-two family caregivers and 52 elderly adults with preexisting impairment according to standardized cognitive testing.

    Measurements: The interviewer-rating for delirium was determined by fulfillment of the CAM algorithm Results: The total sample included 52 paired CAM:FAM-CAM assessments completed across 52 dyads of elderly adults with preexisting cognitive impairment and family caregivers. The point prevalence of delirium was 13% (7/52). Characteristics did not differ significantly between the groups with and without delirium. The FAM-CAM questions that mapped directly to the original four-item CAM algorithm had the best overall agreement with the interviewer-rated CAM (kappa = 0.85, 95% confidence interval (CI) = 0.65�1.0), sensitivity of 88% (95% CI = 47�99%), and specificity of 98% (95% CI = 86�100%).

    Conclusion: The FAM-CAM is a sensitive screening tool for detection of delirium in elderly adults with cognitive impairment using family caregivers, with relevance for research and clinical practice.