Fitzgerald, J;O'Regan, N;Adamis, D;Timmons, S;Dunne, C;Trzepacz, P;Meagher, D

2016

May

International Psychogeriatrics

Concordance between the delirium motor subtyping scale (DMSS) and the abbreviated version (DMSS-4) over longitudinal assessment in elderly medical inpatients

Validated

Altmetric: 7 ()

MOTION ANALYSIS RATING-SCALE MORTALITY RISK PREVALENCE REVISED-98 VALIDATION STABILITY PROGNOSIS PEOPLE

28

845

851

Background: Delirium is a common neuropsychiatric syndrome that includes clinical subtypes identified by the Delirium Motor Subtyping Scale (DMSS). We explored the concordance between the DMSS and an abbreviated 4-item version in elderly medical inpatients. Methods: Elderly general medical admissions (n = 145) were assessed for delirium using the Revised Delirium Rating scale (DRS-R98). Clinical subtype was assessed with the DMSS (which includes the four items included in the DMSS-4). Motor subtypes were generated for all patient assessments using both versions of the scale. The concordance of the original and abbreviated DMSS was examined. Results: The agreement between theDMSS and DMSS-4 was high, both at initial and subsequent assessments (kappa range 0.75-0.91). Intraclass Correlation Coefficient (ICC) for all three raters for theDMSS was high (0.70) and for DMSS-4 was moderate (0.59). Analysis of the agreement between raters for individual DMSS items found higher concordance in respect of hypoactive features compared to hyperactive. Conclusions: TheDMSS-4 allows for rapid assessment of clinical subtype in delirium and has high concordance with the longer and well-validated DMSS, including over longitudinal assessment. There is good inter-rater reliability between medical and nursing staff. More consistent clinical subtyping can facilitate better delirium management and more focused research effort.

NEW YORK

1041-6102

10.1017/S104161021500191X