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Evaluation of a method to estimate the point prevalence of cognitive impairment and delirium in a multi‐campus Australian health service
Author(s) -
Casey Penelope,
Dārziņš Pēteris,
WebbSt Mart Melinda,
Baldwin Cathryn,
Riddell Kath,
Johnson Claire,
Cross Wendy
Publication year - 2019
Publication title -
australasian journal on ageing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.63
H-Index - 34
eISSN - 1741-6612
pISSN - 1440-6381
DOI - 10.1111/ajag.12666
Subject(s) - delirium , cognitive impairment , medicine , confusion , cognition , cognitive test , physical therapy , psychiatry , gerontology , emergency medicine , psychology , psychoanalysis
Objective To design, test (pilot) and implement a study to estimate the point prevalence of cognitive impairment (CI) and delirium in a multi‐site health service. Methods Clinicians were trained to use the 4 A's Test (4AT) to screen for cognitive impairment and delirium, and the 3‐minute Diagnostic Interview for the Confusion Assessment Method (3D‐CAM) to detect delirium in those with abnormal 4AT results. Outcomes of interest were as follows: (a) rates of cognitive impairment and delirium and (b) feasibility of the approach measured by participation rate, “direct survey activity” time, cost and surveyor preparation. Results The rates of cognitive impairment and delirium were 43.8% (245/559) and 16.3% (91/559), respectively. 90.5% (563/622) of eligible adult patients from 25 acute and subacute wards were seen. “Direct survey activities” averaged 14 minutes (range 2‐45) and cost $11.48 per patient. Training evaluation indicated additional education in the 4AT and 3D‐CAM was needed. Conclusion Health services could use this streamlined, inexpensive method to estimate the point prevalence of cognitive impairment and delirium.