Detecting delirium and subsyndromal delirium using different diagnostic criteria among demented long-term care residents.
OBJECTIVE
To evaluate the impact of using different diagnostic criteria on prevalence rates of delirium and subsyndromal delirium (SSD) among demented long-term care (LTC) residents.


METHODS
Descriptive study.


METHODS
LTC settings in Quebec City, Canada.


METHODS
Participants were 155 individuals aged 65 and older, with dementia.


METHODS
(1) Prevalence rates of delirium according to: (a) the Diagnostic and Statistical Manual of Mental Disorders (DSM-III, DSM-III-R, and DSM-IV) and (b) the Confusion Assessment Method (CAM) algorithms for definite and probable delirium; and (2) prevalence rates of SSD employing 2 definitions described in previous studies.


RESULTS
Prevalence rates of delirium according to each set of criteria were 26.5% for DSM-III; 29% for DSM-IV-TR; 41.3% for DSM-III-R; 45.8% for CAM algorithm for definite delirium; and 70.3% for CAM algorithm for probable delirium. A total of 109 subjects (70.3%) were identified as delirious consistent with at least one classification and 37 (23.9%) met all the sets of criteria considered. Prevalence rates for SSD were 75 (48.4%) and 78 (50.3%) depending on the definition employed.


CONCLUSIONS
Prevalence rates for delirium are much affected by the diagnostic formulations used. The use of DSM-IV-TR among this population could result in fewer cases being identified as delirious and thus compromise proper care for those individuals. Considering that SSD was prevalent among this population, a systematic implementation of protocols targeting risk factors of delirium might be beneficial among demented LTC residents.
Voyer
Philippe
P
Faculty of Nursing, Laval University, Laval University Geriatric Research Unit of St-Sacrement Hospital Centre, Quebec City, Canada. Philippe.Voyer@fsi.ulaval.ca
Richard
Sylvie
S
Doucet
Lise
L
Carmichael
Pierre-Hugues
PH
D000368:Aged; D000369:Aged, 80 and over; D003693:Delirium / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D003704:Dementia / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D011792:Quebec / Q000453:epidemiology; D012112:Residential Facilities