Assessment of Delirium Using the Confusion Assessment Method in Older Adult Inpatients in Malaysia
The detection of delirium in acutely ill older patients is challenging with the lack of informants and the necessity to identify subtle and fluctuating signs. We conducted a cross-sectional study among older patients admitted to a university hospital in Malaysia to determine the presence, characteri...
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doaj-80928b2f4c464e179ea65f5fb61a33e32020-11-25T02:01:02ZengMDPI AGGeriatrics2308-34172019-09-01435210.3390/geriatrics4030052geriatrics4030052Assessment of Delirium Using the Confusion Assessment Method in Older Adult Inpatients in MalaysiaHui Min Khor0Hwee Chin Ong1Bee Kuan Tan2Chung Min Low3Nor’Izzati Saedon4Kit Mun Tan5Ai Vyrn Chin6Shahrul B. Kamaruzzaman7Maw Pin Tan8Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 59100, MalaysiaTaylor’s University, Faculty of Health and Medical Sciences, Selangor 47500, MalaysiaTaylor’s University, Faculty of Health and Medical Sciences, Selangor 47500, MalaysiaDepartment of Medicine, Hospital Sultan Ismail, Johor, Johor Bahru 81100, MalaysiaDepartment of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 59100, MalaysiaDepartment of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 59100, MalaysiaDepartment of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 59100, MalaysiaDepartment of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 59100, MalaysiaDepartment of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 59100, MalaysiaThe detection of delirium in acutely ill older patients is challenging with the lack of informants and the necessity to identify subtle and fluctuating signs. We conducted a cross-sectional study among older patients admitted to a university hospital in Malaysia to determine the presence, characteristics, and mortality outcomes of delirium. Consecutive patients aged ≥65years admitted to acute medical wards were recruited from August to September 2016. Cognitive screening was performed using the mini-mental test examination (MMSE) and the Confusion Assessment Method (CAM). The CAM-Severity (CAM-S) score was also performed in all patients. Of 161 patients recruited, 43 (26.7%) had delirium. At least one feature of delirium from the CAM-S short and long severity scores were present in 48.4% and 67.1%, respectively. Older age (OR: 1.07, 95% CI: 1.01−1.14), immobility (OR: 3.16, 95% CI: 1.18−8.50), cognitive impairment (OR: 5.04, 95% CI: 2.07−12.24), and malnutrition (OR: 3.37; 95% CI: 1.15−9.85) were significantly associated with delirium. Older patients with delirium had a higher risk of mortality (OR: 7.87, 95% CI: 2.42−25.57). Delirium is common among older patients in our setting. A large proportion of patients had altered mental status on admission to hospital although they did not fulfill the CAM criteria of delirium. This should prompt further studies on strategies to identify delirium and the use of newer, more appropriate assessment tools in this group of vulnerable individuals.https://www.mdpi.com/2308-3417/4/3/52deliriumolderconfusioninpatienthospitalMalaysia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hui Min Khor Hwee Chin Ong Bee Kuan Tan Chung Min Low Nor’Izzati Saedon Kit Mun Tan Ai Vyrn Chin Shahrul B. Kamaruzzaman Maw Pin Tan |
spellingShingle |
Hui Min Khor Hwee Chin Ong Bee Kuan Tan Chung Min Low Nor’Izzati Saedon Kit Mun Tan Ai Vyrn Chin Shahrul B. Kamaruzzaman Maw Pin Tan Assessment of Delirium Using the Confusion Assessment Method in Older Adult Inpatients in Malaysia Geriatrics delirium older confusion inpatient hospital Malaysia |
author_facet |
Hui Min Khor Hwee Chin Ong Bee Kuan Tan Chung Min Low Nor’Izzati Saedon Kit Mun Tan Ai Vyrn Chin Shahrul B. Kamaruzzaman Maw Pin Tan |
author_sort |
Hui Min Khor |
title |
Assessment of Delirium Using the Confusion Assessment Method in Older Adult Inpatients in Malaysia |
title_short |
Assessment of Delirium Using the Confusion Assessment Method in Older Adult Inpatients in Malaysia |
title_full |
Assessment of Delirium Using the Confusion Assessment Method in Older Adult Inpatients in Malaysia |
title_fullStr |
Assessment of Delirium Using the Confusion Assessment Method in Older Adult Inpatients in Malaysia |
title_full_unstemmed |
Assessment of Delirium Using the Confusion Assessment Method in Older Adult Inpatients in Malaysia |
title_sort |
assessment of delirium using the confusion assessment method in older adult inpatients in malaysia |
publisher |
MDPI AG |
series |
Geriatrics |
issn |
2308-3417 |
publishDate |
2019-09-01 |
description |
The detection of delirium in acutely ill older patients is challenging with the lack of informants and the necessity to identify subtle and fluctuating signs. We conducted a cross-sectional study among older patients admitted to a university hospital in Malaysia to determine the presence, characteristics, and mortality outcomes of delirium. Consecutive patients aged ≥65years admitted to acute medical wards were recruited from August to September 2016. Cognitive screening was performed using the mini-mental test examination (MMSE) and the Confusion Assessment Method (CAM). The CAM-Severity (CAM-S) score was also performed in all patients. Of 161 patients recruited, 43 (26.7%) had delirium. At least one feature of delirium from the CAM-S short and long severity scores were present in 48.4% and 67.1%, respectively. Older age (OR: 1.07, 95% CI: 1.01−1.14), immobility (OR: 3.16, 95% CI: 1.18−8.50), cognitive impairment (OR: 5.04, 95% CI: 2.07−12.24), and malnutrition (OR: 3.37; 95% CI: 1.15−9.85) were significantly associated with delirium. Older patients with delirium had a higher risk of mortality (OR: 7.87, 95% CI: 2.42−25.57). Delirium is common among older patients in our setting. A large proportion of patients had altered mental status on admission to hospital although they did not fulfill the CAM criteria of delirium. This should prompt further studies on strategies to identify delirium and the use of newer, more appropriate assessment tools in this group of vulnerable individuals. |
topic |
delirium older confusion inpatient hospital Malaysia |
url |
https://www.mdpi.com/2308-3417/4/3/52 |
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