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Psychometric evaluation of the DMSS-4 in a cohort of elderly post-operative hip fracture patients with delirium

Published online by Cambridge University Press:  05 February 2016

Dimitrios Adamis
Affiliation:
Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Limerick, Ireland Sligo Mental Health Services, Ballytivnan, Sligo, Ireland
Rikie M. Scholtens
Affiliation:
Department of Internal Medicine, Geriatrics Section, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
Annemarieke de Jonghe
Affiliation:
Department of Geriatrics, Tergooi Hospitals, Hilversum and Blaricum, The Netherlands
Barbara C. van Munster
Affiliation:
University Center for Geriatric Medicine, University Medical Center Groningen, Groningen, The Netherlands Department of Geriatrics, Gelre Hospitals, Apeldoorn, The Netherlands
Sophia E.J.A. de Rooij
Affiliation:
University Center for Geriatric Medicine, University Medical Center Groningen, Groningen, The Netherlands
David J. Meagher
Affiliation:
Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Limerick, Ireland Department of Psychiatry, University Hospital Limerick, Limerick, Ireland
Corresponding
E-mail address:

Abstract

Background:

Delirium is a common neuropsychiatric syndrome with considerable heterogeneity in clinical profile. Rapid reliable identification of clinical subtypes can allow for more targeted research efforts.

Methods:

We explored the concordance in attribution of motor subtypes between the Delirium Motor Subtyping Scale 4 (DMSS-4) and the original Delirium Motor Subtyping Scale (DMSS) (assessed cross-sectionally) and subtypes defined longitudinally using the Delirium Symptom Interview (DSI).

Results:

We included 113 elderly patients developing DSM-IV delirium after hip-surgery [mean age 86.9 ± 6.6 years; range 65–102; 68.1% females; 25 (22.1%) had no previous history of cognitive impairment]. Concordance for the first measurement was high for both the DMSS-4 and original DMSS (k = 0.82), and overall for the DMSS-4 and DSI (k = 0.84). The DMSS-4 also demonstrated high internal consistency (McDonald's omega = 0.90). The DSI more often allocated an assessment to “no subtype” compared to the DMSS-4 and DMSS-11, which showed higher inclusion rates for motor subtypes.

Conclusions:

The DMSS-4 provides a rapid method of identifying motor-defined clinical subtypes of delirium and appears to be a reliable alternative to the more detailed and time-consuming original DMSS and DSI methods of subtype attribution. The DMSS-4, so far translated into three languages, can be readily applied to further studies of causation, treatment and outcome in delirium.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2016 

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