Journal of the American Geriatrics Society

Brief Methodological Reports

Screening for Delirium Using Family Caregivers: Convergent Validity of the Family Confusion Assessment Method and Interviewer-Rated Confusion Assessment Method

Corresponding Author

Melinda R. Steis PhD, RN

*Department of Veterans Affairs Medical Center, Orlando, Florida

Address correspondence to Dr. Melinda R. Steis, Department of Veterans Affairs, Orlando VA Medical Center, 2900 Veterans Way, Melbourne, FL 32940. E-mail: [email protected]Search for more papers by this author

Lois Evans PhD, RN,

Lois Evans PhD, RN

School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania

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Karen B. Hirschman PhD, MSW,

Karen B. Hirschman PhD, MSW

School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania

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Alexandra Hanlon PhD,

Alexandra Hanlon PhD

School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania

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Donna M. Fick PhD, RN,

Donna M. Fick PhD, RN

School of Nursing, Pennsylvania State University, University Park, Pennsylvania

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Nina Flanagan PhD, RN,

Nina Flanagan PhD, RN

Decker School of Nursing, Binghamton University, Binghamton, New York

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Sharon K. Inouye MD, MPH,

Sharon K. Inouye MD, MPH

Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA

Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife, Boston, MA

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Melinda R. Steis PhD, RN,

Corresponding Author

Melinda R. Steis PhD, RN

*Department of Veterans Affairs Medical Center, Orlando, Florida

Lois Evans PhD, RN,

Lois Evans PhD, RN

School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania

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Karen B. Hirschman PhD, MSW,

Karen B. Hirschman PhD, MSW

School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania

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Alexandra Hanlon PhD,

Alexandra Hanlon PhD

School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania

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Donna M. Fick PhD, RN,

Donna M. Fick PhD, RN

School of Nursing, Pennsylvania State University, University Park, Pennsylvania

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Nina Flanagan PhD, RN,

Nina Flanagan PhD, RN

Decker School of Nursing, Binghamton University, Binghamton, New York

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Sharon K. Inouye MD, MPH,

Sharon K. Inouye MD, MPH

Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA

Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife, Boston, MA

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First published: 05 October 2012

https://doi.org/10.1111/j.1532-5415.2012.04200.x

Citations: 92

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Abstract

Objectives

To explore agreement between the Family Confusion Assessment Method (FAM-CAM) for delirium identification and interviewer-rated CAM delirium ratings.

Design

Exploratory analysis of agreement.

Setting

Community.

Participants

Fifty-two family caregivers and 52 elderly adults with preexisting impairment according to standardized cognitive testing.

Measurements

The interviewer-rating for delirium was determined by fulfillment of the CAM algorithm

Results

The total sample included 52 paired CAM:FAM-CAM assessments completed across 52 dyads of elderly adults with preexisting cognitive impairment and family caregivers. The point prevalence of delirium was 13% (7/52). Characteristics did not differ significantly between the groups with and without delirium. The FAM-CAM questions that mapped directly to the original four-item CAM algorithm had the best overall agreement with the interviewer-rated CAM (kappa = 0.85, 95% confidence interval (CI) = 0.65–1.0), sensitivity of 88% (95% CI = 47–99%), and specificity of 98% (95% CI = 86–100%).

Conclusion

The FAM-CAM is a sensitive screening tool for detection of delirium in elderly adults with cognitive impairment using family caregivers, with relevance for research and clinical practice.

References

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Citing Literature

Volume60, Issue11

November 2012

Pages 2121-2126

Screening for Delirium Using Family Caregivers: Convergent Validity of the Family Confusion Assessment Method and Interviewer-Rated Confusion Assessment Method

Abstract

Objectives

Design

Setting

Participants

Measurements

Results

Conclusion

References

Citing Literature

References

Information

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Screening for Delirium Using Family Caregivers: Convergent Validity of the Family Confusion Assessment Method and Interviewer-Rated Confusion Assessment Method

Abstract

Objectives

Design

Setting

Participants

Measurements

Results

Conclusion

References

Citing Literature

References

Related

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