Journal
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
Volume 60, Issue 11, Pages 2121-2126Publisher
WILEY
DOI: 10.1111/j.1532-5415.2012.04200.x
Keywords
delirium; Confusion Assessment Method (CAM); dementia; caregiver
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Funding
- Department of Veterans Affairs, Veterans Health Administration Employee Education System, Indianapolis, Indiana
- Marian S. Ware Alzheimer Program, University of Pennsylvania
- National Institute on Aging [R01AG023116, P01AG031720, R01 NR011042]
- Children, Youth, and Families Consortium of the Penn State Social Science Research Institute
- Smart Spaces Initiative at Penn State
- University of Pennsylvania School of Nursing [T32NR009356]
- National Institute of Nursing Research
- Alzheimer's Association [IIRG-08-88, 738]
- Hospital Elder Life Program
- Milton and Shirley F. Levy Family Chair
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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) = 0.651.0), 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. J Am Geriatr Soc 60: 2121-2126, 2012.
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