title: Screening for delirium using family caregivers: convergent validity of the Family Confusion Assessment Method and interviewer-rated Confusion Assessment Method.
abstract: OBJECTIVE
  To explore agreement between the Family Confusion Assessment Method (FAM-CAM) for delirium identification and interviewer-rated CAM delirium ratings.
  
  
  METHODS
  Exploratory analysis of agreement.
  
  
  METHODS
  Community.
  
  
  METHODS
  Fifty-two family caregivers and 52 elderly adults with preexisting impairment according to standardized cognitive testing.
  
  
  METHODS
  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%).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Veterans Affairs Medical Center, Orlando, Florida 32940, USA. melinda.steis@va.gov
authors.forename: Melinda R
authors.initials: MR
authors.lastname: Steis
authors.forename: Lois
authors.initials: L
authors.lastname: Evans
authors.forename: Karen B
authors.initials: KB
authors.lastname: Hirschman
authors.forename: Alexandra
authors.initials: A
authors.lastname: Hanlon
authors.forename: Donna M
authors.initials: DM
authors.lastname: Fick
authors.forename: Nina
authors.initials: N
authors.lastname: Flanagan
authors.forename: Sharon K
authors.initials: SK
authors.lastname: Inouye
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D003693:Delirium / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results