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Quantifying the association between computerised measures of attention and confusion assessment method defined delirium: a prospective study of older orthopaedic surgical patients, free of dementia

Lowery, David, Wesnes, Keith, Brewster, Nigel, Ballard, Clive G. (2008) Quantifying the association between computerised measures of attention and confusion assessment method defined delirium: a prospective study of older orthopaedic surgical patients, free of dementia. International Journal of Geriatric Psychiatry, 23 (12). pp. 1253-1260. ISSN 0885-6230. (doi:10.1002/gps.2059) (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided) (KAR id:36493)

The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided.
Official URL
http://dx.doi.org/10.1002/gps.2059

Abstract

Objective

To determine whether attentional impairments are reliable neuropsychological markers of delirium.

Method

A prospective cohort of one hundred patients admitted for elective orthopaedic surgery, 70 years and over, and free of dementia were recruited from an Orthopaedic unit in a university teaching hospital. Computerized assessments of attention and the Mini Mental State Examination were administered pre and post operatively. The Confusion Assessment Method was used to evaluate signs and symptoms of delirium.

Results

Over the first post operative week after surgery people with delirium scored lower on the MMSE (F?=?23.53 (1, 53); p?=?0.000); and performed less accurately (F?=?20.02 (1, 55); p?=?0.000), slower (F?=?14.58 (1, 54); p?=?0.000) and with greater variability of reaction time (F?=?31.52 (1, 53); p?=?0.000) than people without delirium. The group with delirium's neuropsychological performance was marked by a quadratic trend of accuracy (F?=?10.5 (1, 8); p?=?0.018) across the first post operative week. Conversely the group without delirium demonstrate quadratic trends for reaction time (F?=?6.91 (1, 49); p?=?0.011); and linear trends for the variability of reaction time (F?=?7.06 (1, 49); p?=?0.011) over this period.

Conclusions

To date the absence of any well validated neuropsychological markers of delirium has hindered progress of research of delirium. The data within this study suggest key indices of attention and in particular fluctuating cognition may offer excellent discriminative utility for this clinically important condition.

Item Type: Article
DOI/Identification number: 10.1002/gps.2059
Uncontrolled keywords: delirium;neuropsychological;markers;attention deficits;fluctuating cognition
Subjects: R Medicine > RC Internal medicine > RC321 Neuroscience. Biological psychiatry. Neuropsychiatry
R Medicine > RC Internal medicine > RC952 Geriatrics
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Centre for Health Services Studies
Depositing User: Tony Rees
Date Deposited: 15 Nov 2013 15:17 UTC
Last Modified: 16 Nov 2021 10:13 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/36493 (The current URI for this page, for reference purposes)
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