An observational study to assess the performance of the 4AT tool for measuring recovery from delirium in hospitalised older people
- Conditions
- Assessing delirium in older hospitalised patients - a severe and distressing neuropsychiatric syndrome which is characterised by acute deterioration in attention and other mental functions.Mental and Behavioural Disorders
- Registration Number
- ISRCTN48221972
- Lead Sponsor
- niversity of Edinburgh and NHS Lothian Health Board
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Ongoing
- Sex
- All
- Target Recruitment
- 150
1. Surgical (cardiac and hip fracture) and medical patients with current delirium
2. Aged 70 years or older
3. Capacity to provide written, informed consent or the availability of a suitable relative or welfare guardian/attorney who is able to provide informed consent on behalf of the patient
1. Unable to communicate in English (some of the cognitive tests used have not been validated in non-English speakers, hence the study only includes patients who can normally communicate fluently in English), including severe dysphasia.
2. Acute life-threatening illness requiring time-critical intervention.
3. Coma.
4. Vision or hearing impairment severe enough to preclude testing or interview.
5. Photosensitive epilepsy.
6. High level of patient and family distress, as judged by the clinical team.
Study & Design
- Study Type
- Observational
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Delirium recovery measured using brief questionnaires and observational scales (reference and index assessments). The index assessment consists of the 4AT test plus brief supplementary tests, specifically the Days of the Week Backwards test. This will be compared against a more comprehensive reference assessment (including Vigilance A test, DelApp, 20 to 1, DRS-R98) to assess attentional function, orientation, memory, psychotic features, etc. at baseline and up to 3 further assessment days in hospital.
- Secondary Outcome Measures
Name Time Method <br> 1. Demographic and baseline variables such as age, medications, body measurements (height, weight, BMI), main reason for hospital admission, social history (including alcohol misuse and tobacco use) and health status (including dementia diagnosis or psychiatric/developmental condition), extracted from NHS electronic patient medical records at baseline.<br> 2. Length of stay, institutionalisation, discharge location and mortality will be assessed at 12 weeks post-recruitment, also from NHS electronic patient medical records.<br>