Concordance between the Delirium Motor Subtyping Scale (DMSS) and the Abbreviated version (DMSS-4) over longitudinal assessment of elderly medical inpatients

David Meagher, James Fitzgerald, Niamh O'Regan, Dimitrios Adamis, Suzanne Timmons, Colum Dunne, Paula Trzepacz

Research output: Contribution to journalArticlepeer-review

Abstract

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 the DMSS and DMSS-4 was high, both at initial and subsequent assessments (κ range 0.75-0.91). Intraclass Correlation Coefficient (ICC) for all three raters for the DMSS 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: The DMSS-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.

Original languageEnglish (Ireland)
Pages (from-to)845-851
Number of pages7
JournalInternational psychogeriatrics
Volume28
Issue number5
DOIs
Publication statusPublished - 1 May 2016

Keywords

  • activity
  • assessment
  • delirium
  • motor
  • phenomenology
  • subtypes

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