title: Variability of Delirium Motor Subtype Scale-Defined Delirium Motor Subtypes in Elderly Adults with Hip Fracture: A Longitudinal Study.
abstract: OBJECTIVE
  To examine changes in motor subtype profile in individuals with delirium.
  
  
  METHODS
  Observational, longitudinal study; substudy of a multicenter, randomized controlled trial.
  
  
  METHODS
  Departments of surgery and orthopedics, Academic Medical Center and Tergooi Hospital, the Netherlands.
  
  
  METHODS
  Elderly adults acutely admitted for hip fracture surgery who developed delirium according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, for 2 days or longer (n = 76, aged 86.4 ± 6.1, 68.4% female).
  
  
  METHODS
  Delirium Motor Subtype Scale (DMSS), Delirium Rating Scale R98 (DRS-R98), comorbidity, and function.
  
  
  RESULTS
  Median delirium duration was 3 days (interquartile range 2.0 days). At first assessment, the hyperactive motor subtype was most common (44.7%), followed by hypoactive motor subtype (28.9%), mixed motor subtype (19.7%), and no motor subtype (6.6%). Participants with no motor subtype had lower DRS-R98 scores than those with the other subtypes (P < .001). The DMSS-defined motor subtype of 47 (61.8%) participants changed over time. Katz Index of Activities of Daily Living, Charlson Comorbidity Index, cognitive impairment, age, sex, and delirium duration or severity were not associated with change in motor subtype.
  
  
  CONCLUSIONS
  Motor subtype profile was variable in the majority of participants, although changes that occurred were often related to changes from or to no motor subtype, suggesting evolving or resolving delirium. Changes appeared not be associated with demographic or clinical characteristics, suggesting that evidence from cross-sectional studies of motor subtypes could be applied to many individuals with delirium. Further longitudinal studies should be performed to clarify the stability of motor subtypes in different clinical populations.
authors.affiliation: Geriatrics Section, Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Rikie M
authors.initials: RM
authors.lastname: Scholtens
authors.affiliation: Department of Geriatrics, Gelre Hospitals, Apeldoorn, The Netherlands.|University Center for Geriatric Medicine, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Barbara C
authors.initials: BC
authors.lastname: van Munster
authors.affiliation: Sligo Mental Health Services, Ballytivnan, Sligo, Ireland.|Research and Academic Institute of Athens, Athens, Greece.|Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation and Immunity, Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Adamis
authors.affiliation: Department of Geriatrics, Tergooi Hospital, Hilversum and Blaricum, the Netherlands.
authors.forename: Annemarieke
authors.initials: A
authors.lastname: de Jonghe
authors.affiliation: Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation and Immunity, Graduate Entry Medical School, University of Limerick, Limerick, Ireland.|Department of Psychiatry, University Hospital Limerick, Limerick, Ireland.
authors.forename: David J
authors.initials: DJ
authors.lastname: Meagher
authors.affiliation: Geriatrics Section, Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.|University Center for Geriatric Medicine, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Sophia E J A
authors.initials: SE
authors.lastname: de Rooij
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003693:Delirium / Q000145:classification / Q000453:epidemiology*; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008609:Mental Status Schedule; D009426:Netherlands / Q000453:epidemiology; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D011596:Psychomotor Disorders / Q000145:classification / Q000209:etiology* / Q000523:psychology
keywords: 
  DMSS
  ; delirium; elderly; hip fracture; subtypes