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Journal of General Internal Medicine

, Volume 34, Issue 3, pp 354–355 | Cite as

Does a Year Have 6 Months or 12? Implications for Delirium Detection Among Hospitalized Older General Medicine Patients

  • Wenxiao Zhou
  • Long H. Ngo
  • Sharon K. Inouye
  • Jacqueline Gallagher
  • Erica K. Husser
  • Donna M. Fick
  • Edward R. MarcantonioEmail author
Concise Research Reports

BACKGROUND

Delirium is common, morbid, and costly, yet less than half of all cases are recognized clinically.1 Since inattention is a key feature of delirium, attention items are excellent screening tools for delirium.2 Months of the year backwards (MOYB) has been identified as the best single delirium screening item.2,3 Yet, there is significant variation in how MOYB is administered and scored. Some tools recommend asking the patient to recite all months from December to January,3 while others suggest reciting only from December to July.2,4

OBJECTIVE

Our aim was to evaluate these two MOYB administration strategies when MOYB is used as a single-item delirium screen, as part of a previously reported ultra-brief 2-item screen,3 and as part of the validated 3D-CAM diagnostic assessment.5

METHODS

Data is from 201 general medicine patients (≥ 75 years old) enrolled in our 3D-CAM validation study.5Participants were administered a detailed evaluation for delirium by a trained clinician...

Notes

Funding Sources

This work was supported by the following grants: R01AG030618 (Marcantonio/Fick), K24AG035075 (Marcantonio), R24AG054259 (Inouye), and R01AG044518 (Inouye), all from the National Institute on Aging. The funding sources had no role in the drafting or submission of this manuscript.

Compliance with Ethical Standards

Human Subjects

The Institutional Review Board of the Beth Israel Deaconess Medical Center approved all human subjects’ research activities in this manuscript—IRB protocols 2008-P-000165 and 2015-P-00096.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

References

  1. 1.
    Marcantonio ER. Delirium in Hospitalized Older Adults. N Engl J Med. 2017;377:1456–1466. Review.CrossRefGoogle Scholar
  2. 2.
    O’Regan NA, Ryan DJ, Boland E, et al. Attention! A good bedside test for delirium? J Neurol Neurosurg Psychiatry. 2014;85:1122–1131.CrossRefGoogle Scholar
  3. 3.
    Fick DM, Inouye SK, Guess J, et al. Preliminary development of an ultrabrief two-item bedside test for delirium. J Hosp Med. 2015;10:645–650.CrossRefGoogle Scholar
  4. 4.
    Han JH, Wilson A, Vasilevskis EE, et al. Diagnosing delirium in older emergency department patients: validity and reliability of the delirium triage screen and the brief confusion assessment method. Ann Emerg Med. 2013;62:457–465.CrossRefGoogle Scholar
  5. 5.
    Marcantonio ER, Ngo LH, O'Connor M, et al. 3D-CAM: derivation and validation of a 3-minute diagnostic interview for CAM-defined delirium: a cross-sectional diagnostic test study. Ann Intern Med. 2014;161:554–561.CrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2018

Authors and Affiliations

  • Wenxiao Zhou
    • 1
  • Long H. Ngo
    • 1
    • 2
  • Sharon K. Inouye
    • 2
    • 3
    • 4
  • Jacqueline Gallagher
    • 1
  • Erica K. Husser
    • 5
  • Donna M. Fick
    • 5
  • Edward R. Marcantonio
    • 1
    • 2
    • 4
    Email author
  1. 1.Division of General Medicine, Department of MedicineBeth Israel Deaconess Medical CenterBostonUSA
  2. 2.Harvard Medical SchoolBostonUSA
  3. 3.Aging Brain CenterInstitute for Aging Research, Hebrew SeniorLifeBostonUSA
  4. 4.Division of Gerontology, Department of MedicineBeth Israel Deaconess Medical CenterBostonUSA
  5. 5.Colleges of Nursing and MedicineThe Pennsylvania State University, University ParkState CollegeUSA

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