Memorial Delirium Assessment Scale

Breitbart, William; Rosenfeld, Barry; Roth, Andrew; Smith, M. J.; Cohen, K; Passik, Steven D.

doi:10.1037/t19825-000

Cited by 163 publications

(233 citation statements)

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“…27,28 Tools that measure the severity of delirium are most often used in clinical research studies to assess changes in delirium over time. 29,30 Early recognition and diagnosis of delirium in a critically ill patient on a ventilator in the ICU can be challenging because of the patient's inability to communicate verbally. Several validated assessment tools are available for identifying patients at risk for delirium in the ICU.…”

Section: Is This Confusion Due To Delirium?mentioning

confidence: 99%

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A Review of Recent Clinical Trials and Guidelines on the Prevention and Management of Delirium in Hospitalized Older Patients

Rathier

Baker

2011

Hospital Practice

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Treatment of acute illness in older adults is frequently complicated by the presence of delirium. Delirium is characterized by the development of an altered mental status over the course of hours to days, and can have a fluctuating course. Patients with delirium have difficulty paying attention to their environment, have disorganized thinking, and usually have an altered level of consciousness. While scientists continue to elucidate the pathophysiologic mechanisms associated with delirium, clinicians can identify patients at risk for delirium and diagnose it using valid instruments, such as the Confusion Assessment Method and Confusion Assessment Method for the Intensive Care Unit. Delirium is an independent risk factor for death, institutionalization, and dementia, and resolves in many patients by the time of hospital discharge. For patients admitted to medical units, optimal management of delirium includes reassessment of medications, pain, sleep, nutrition, mobility, need for physical restraints, and bowel and bladder function. The use of antipsychotic medication to sedate delirious patients should be restricted to patients in danger of harming themselves or others and should be used when nonpharmacologic means fail. Multicomponent interventions performed by the hospital care team that address risk factors can prevent delirium in patients in medical units and those undergoing hip fracture repair. This includes attention to the depth of sedation during spinal anesthesia and the addition of regional nerve blocks to patient-controlled analgesia in orthopedic patients, both of which may reduce postoperative delirium. Perioperative use of antipsychotics may further reduce the incidence of delirium, although hospital length of stay has not been routinely reduced. Appropriate management of analgesia, sedation, and delirium in the intensive care unit is also associated with reduced duration of mechanical ventilation, as well as intensive care unit and hospital length of stay. The use of dexmedetomidine, an α-adrenergic receptor agonist, for sedation may reduce intensive care unit length of stay when compared with use of benzodiazepines.

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Section: Is This Confusion Due To Delirium?mentioning

confidence: 99%

“…Thirteen-item symptom scale can be repeated to detect change in severity. Memorial Delirium Assessment Scale (MDAS) 30 Consists of a 10-item scale to quantify severity of delirium and detect change in symptoms. Takes 10 minutes.…”

Section: Instruments To Rate Severity Of Deliriummentioning

confidence: 99%

A Review of Recent Clinical Trials and Guidelines on the Prevention and Management of Delirium in Hospitalized Older Patients

Rathier

Baker

2011

Hospital Practice

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“…The agitation severity of hyperactive delirium was also assessed from the records of the last week by the psychiatrist using the ''psychomotor activity'' item (Item 9) of the Memorial Delirium Assessment Scale (MDAS) following the previous studies. 13,18,19 The rationale for adopting this end-point was that (1) there is no validated method for assessing severity of agitation retrospectively, (2) several studies showed that MDAS Item 9 was associated with neurobehavioral dimension and severity of agitation, 20-22 and (3) it was assumed that remarkable events related to the patients with hyperactive delirium were usually well described in the medical records as a part of routine practice. Then the agitation severity (response variable) was categorized according to an ad hoc scale referring MDAS as follows: 0, no agitation (no episode of delirium or hypoactive delirium); 1, mild; 2, moderate; and 3, severe.…”

Section: Delirium Assessmentmentioning

confidence: 99%

Predictive Factors for Agitation Severity of Hyperactive Delirium in Terminally Ill Cancer Patients in a General Hospital Using Ordered Logistic Regression Analysis

Kanbayashi

Hatano²,

Hata³

et al. 2013

Journal of Palliative Medicine

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“…The commonly used delirium scales are the Delirium Rating Scale-Revised 98, the Memorial Delirium Assessment Scale (MDAS), and the Confusion Assessment Method (CAM). [52][53][54][55][56][57] The MDAS is a ten-item delirium screening and assessment tool, validated among hospitalized patients with advanced cancer and AIDS. 54 A cutoff score of 13 is diagnostic of delirium.…”

Section: Deliriummentioning

confidence: 99%

“…[52][53][54][55][56][57] The MDAS is a ten-item delirium screening and assessment tool, validated among hospitalized patients with advanced cancer and AIDS. 54 A cutoff score of 13 is diagnostic of delirium. The MDAS has been revalidated among advanced cancer patients in inpatient palliative care settings with a sensitivity of 98% and a specificity of 96% at a cutoff score of 7.…”

Section: Deliriummentioning

confidence: 99%

Psycho-Oncology

Breitbart

Alici

2009

Harvard Review of Psychiatry

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The psychosocial and psychiatric sequelae of cancer are highly prevalent, diverse, and challenging for clinicians to manage. A growing body of literature has generated methods for the reliable screening, assessment, and management of these sequelae, including the treatment of psychiatric disorders that may complicate the course of cancer. To meet the specific needs of this patient population, psycho-oncologists worldwide have begun to train more and more social workers, psychologists, and psychiatrists who can provide consultative services in support of the psychiatric care of cancer patients and their families at all stages of disease, including cancer survivorship. This review presents an overview of the history of psycho-oncology, common psychological responses to cancer, factors in adapting to cancer, epidemiology, the assessment and management of major psychiatric disorders in cancer patients, cancer-related fatigue, the cognitive effects of cancer and cancer treatment, issues related to the psychosocial care of families (including bereavement), and psychological issues for staff caring for cancer patients.

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Memorial Delirium Assessment Scale

Cited by 163 publications

References 0 publications

A Review of Recent Clinical Trials and Guidelines on the Prevention and Management of Delirium in Hospitalized Older Patients

A Review of Recent Clinical Trials and Guidelines on the Prevention and Management of Delirium in Hospitalized Older Patients

Predictive Factors for Agitation Severity of Hyperactive Delirium in Terminally Ill Cancer Patients in a General Hospital Using Ordered Logistic Regression Analysis

Psycho-Oncology

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