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

Identifier:  imarina:9432967

Handle: https://hdl.handle.net/20.500.11797/imarina9432967

Authors:  Sepúlveda, E; Bermúdez, E; Vallinoto, L; Sánchez, J; Saura, P; Piany, P; Viñuelas, E; Ciutat, M; Palma, J; Grau, I; Vilella, E; Voyer, P; Franco, JG

Abstract:
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 independently 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 subsyndromal delirium (SSD). We evaluated the test-retest temporal stability of the morning and midday 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 diagnostic accuracy of the midday assessment for delirium (79.4 %) was better than that of the morning (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.