Relationship between cognitive status at admission and incident delirium in older medical inpatients.

To evaluate the relationship between cognitive status and incident delirium, 291 geriatric patients on internal medicine wards were evaluated on admission with the Mini-Mental State Examination (MMSE) and Confusion Assessment Method-Spanish. Those with incident delirium were assessed using the Delirium Rating Scale-Revised-98 (DRS-R98). Delirium incidence was 11.7%, and 82 patients (28.2%) had cognitive deficits on MMSE. As cognitive impairment worsened, the risk for delirium increased linearly, and for each unit of MMSE worsening the DRS-R98 severity score worsened 0.4 points (F=5.39, df=1, p=0.027). Optimal MMSE cutoff score from receiver-operating characteristic curve analysis was 24.5. Even mild cognitive deficits increase delirium risk and severity.

Factor analysis of the Colombian translation of the Delirium Rating Scale (DRS), Revised-98.

BACKGROUND: The phenomenology of delirium needs further elucidation using validated tools. OBJECTIVE: The authors sought to derive valid factors from the Delirium Rating Scale (DRS), Revised -98. METHOD: A factor analysis of the DRS-R-98 was performed among 161 medical-surgical patients. RESULTS: Scores ranged from 0 to 7 in 120 patients (74.53%; no delirium), 8 to 13 in 19 (11.80%; subclinical/prodromal delirium), and > or = 14 in 22 (13.66%; delirium). The DSM-IV-TR delirium incidence was 19.87%. The first two rotated factors explained 63.37% of the variance and may correspond to Cognition and Psychosis/Agitation factors. The dimension of motor retardation loaded with cognitive items. Motor agitation and retardation clustered with inattention, which is the cardinal symptom of delirium. CONCLUSION: The DRS-R-98 has good construct validity in this Latino population.