Validating a new clinical subtyping scheme for delirium with electronic motion analysis

Psychiatry Res. 2010 Jun 30;178(1):186-90. doi: 10.1016/j.psychres.2009.04.010. Epub 2010 May 10.

Abstract

The usefulness of motor subtypes of delirium is unclear due to inconsistency in sub-typing methods and a lack of validation with objective measures of activity. The activity of 40 patients was measured with 24 h accelerometry monitoring. Patients with Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) delirium (n=30) were allocated into hyperactive, hypoactive and mixed motor subtypes. Delirium subtypes differed in relation to overall amount of activity, including movement in both sagittal and transverse planes. Differences were greater in the daytime and during the early evening 'sundowning' period. Frequency of postural changes was the most discriminating measure examined. Clinical subtypes of delirium defined by observed motor behaviour on the ward differ in electronically measured activity levels.

MeSH terms

  • Accelerometry
  • Adult
  • Aged
  • Aged, 80 and over
  • Checklist
  • Delirium / classification*
  • Delirium / diagnosis*
  • Diagnosis, Computer-Assisted / instrumentation
  • Diagnosis, Computer-Assisted / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Movement*
  • Neuropsychological Tests
  • Psychiatric Status Rating Scales