title: Informant single screening questions for delirium and dementia in acute care--a cross-sectional test accuracy pilot study.
abstract: BACKGROUND
  Cognitive impairment often goes undetected in older people in hospital. Efficient screening tools are required to improve detection. To determine diagnostic properties of two separate informant-based single screening questions for cognitive impairment (dementia and delirium) in hospitalised older people.
  
  
  METHODS
  Patients over 65 years non-electively admitted to medical or geriatric wards within a teaching hospital. Our index tests were single screening questions (SSQ), one for dementia ("How has your relative/friend's memory changed over the past 5 years (up to just before their current illness)?") and one for delirium ("How has your relative/friend's memory changed with his/her current illness?"), which were assessed with informant response given on a five point Likert scale. Any deterioration on our index tests of SSQ-dementia and SSQ-delirium was accepted as a positive screen for cognitive impairment. Scores were compared to the Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE) >3.38 accepted as dementia, and Confusion Assessment Method (CAM) diagnosis of delirium. We also collected direct cognitive screening data using Mini Mental Status Examination (MMSE).
  
  
  RESULTS
  Informant responses were obtained in 70/161 (43.5%) patients, median age 80.8 (range:67-97) years; mean MMSE score 18.5 (SD: 8.1). The SSQ-dementia when compared to the IQCODE had a sensitivity of 83.3% and specificity of 93.1%. The SSQ-delirium when compared to CAM diagnosis had sensitivity of 76.9% and a specificity of 56.1%.
  
  
  CONCLUSIONS
  These findings show promise for use of an informant single screening question tool as the first step in detection of dementia in older people in acute hospital care, although this approach appears to be less accurate in screening for delirium.
authors.affiliation: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. kirsty.hendry0@gmail.com.|Academic Section of Geriatric Medicine, Institute of Cardiovascular and Medical Sciences, Room 2:03, 2nd floor New Lister Building Glasgow Royal Infirmary, Glasgow, G31 2ER, UK. kirsty.hendry0@gmail.com.
authors.forename: Kirsty
authors.initials: K
authors.lastname: Hendry
authors.affiliation: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. Terry.Quinn@glasgow.ac.uk.|Academic Section of Geriatric Medicine, Institute of Cardiovascular and Medical Sciences, Room 2.44, 2nd floor New Lister Building Glasgow Royal Infirmary, Glasgow, G31 2ER, UK. Terry.Quinn@glasgow.ac.uk.
authors.forename: Terence J
authors.initials: TJ
authors.lastname: Quinn
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK. Jonathan.Evans@glasgow.ac.uk.|Mental Health and Wellbeing, University of Glasgow, The Academic Centre, Gartnavel Royal Hospital, R212 Level 2, 1055 Great Western Road, Glasgow, G12 0XH, UK. Jonathan.Evans@glasgow.ac.uk.
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: Evans
authors.affiliation: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. David.J.Stott@glasgow.ac.uk.|Academic Section of Geriatric Medicine, Institute of Cardiovascular and Medical Sciences, Room 9, 2nd floor New Lister building Glasgow Royal Infirmary, Glasgow, G31 2ER, UK. David.J.Stott@glasgow.ac.uk.
authors.forename: David J
authors.initials: DJ
authors.lastname: Stott
mesh_terms: D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D003430:Cross-Sectional Studies; D003693:Delirium / Q000175:diagnosis* / Q000523:psychology; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D010865:Pilot Projects; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires