Resumen de Screening time for delirium in dementia patients matters: Validation of the Spanish version of the RADAR

Esteban Sepúlveda Ramos, Ester Bermudez, Lourdes Vallinoto, Julia Sánchez, Paola Saura, Pau Piany, Eva Viñuelas, Marta Ciutat, Jose Palma, Imma Grau, Elisabet Vilella Cuadrada, Philippe Voyer, Jose Gabriel Franco

• Background and objectives: Delirium is frequently underdiagnosed in patients with dementia.

  The Reperage Actif du Delirium Adapte a la Routine (RADAR) can be adapted to nursing routines for delirium screening. We validated the Spanish RADAR version and determined the best time of day for its administration.

  Methods: All dementia patients admitted to a postacute care centre on one day were indepen- dently assessed by nurses using the RADAR at the morning and midday and by geriatricians with the Delirium Diagnostic Tool-Provisional (DDT-Pro) reference standard for delirium and subsyn- dromal delirium (SSD). We evaluated the test−retest temporal stability of the morning and mid- day RADAR assessments, the RADAR validity considering these two time points and then, the suitability of the DDT-Pro for diagnostic confirmation.

  Results: Of 34 dementia patients included, 47.1 % had delirium, and 83.3 % had behavioural, mental or neurological disturbances that made diagnostic assessment difficult. The test−retest temporal stability of the RADAR was moderate, which is consistent with the fact that the diag- nostic accuracy of the midday assessment for delirium (79.4 %) was better than that of the morn- ing (73.5 %). The screening accuracy when also considering SSD, accounting for either assessment time, was 79.4 %. Several correspondence and correlation analyses support the use of DDT-Pro for confirmation and assessment of delirium severity after RADAR screening Conclusion: The RADAR is useful for the screening of delirium and SSD by nurses in dementia patients and midday assessments have greater diagnostic validity than morning assessments.

  Screened patients need subsequent diagnosis confirmation before starting therapeutic measures.

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