Screening for delirium using family caregivers: Convergent validity of the family confusion assessment method and interviewer-rated confusion assessment method

Melinda R. Steis, Lois Evans, Karen B. Hirschman, Alexandra Hanlon, Donna M. Fick, Nina Flanagan, Sharon K. Inouye

Research output: Contribution to journalArticlepeer-review

62 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)2121-2126
Number of pages6
JournalJournal of the American Geriatrics Society
Volume60
Issue number11
DOIs
StatePublished - Nov 2012

All Science Journal Classification (ASJC) codes

  • Geriatrics and Gerontology

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