JAMDA
Volume 10, Issue 6 , Pages 379-380 , July 2009

The Development of a Mental Status Vital Sign for Use Across the Spectrum of Care

  • Joseph H. Flaherty, MD

      Affiliations

    • Geriatric Research, Education and Clinical Center (GRECC), St. Louis VA Medical Center, Division of Geriatrics, Saint Louis University School of Medicine, St. Louis, MO
    • Corresponding Author InformationAddress correspondence to Joseph H. Flaherty, MD, Saint Louis University School of Medicine, Geriatrics, 1402 S. Grand Boulevard, M238, St. Louis, MO 63104.
    • ,
  • Kenneth Shay, DDS, MS

      Affiliations

    • Office of Geriatrics and Extended Care, US Department of Veterans Affairs, Ann Arbor, MI
    • ,
  • Charlene Weir, PhD, RN

      Affiliations

    • GRECC, Salt Lake City VA Medical Center, Salt Lake City, UT
    • ,
  • Barbara Kamholz, MD

      Affiliations

    • GRECC, Durham VA Medical Center and Duke University, Durham, NC
    • ,
  • Kenneth S. Boockvar, MD, MS

      Affiliations

    • GRECC, James J. Peters VA Medical Center, Bronx, NY
    • Mount Sinai School of Medicine, New York, NY
    • Jewish Home Lifecare, New York, NY
    • ,
  • Marianne Shaughnessy, PhD, CRNP

      Affiliations

    • GRECC, Baltimore VA Medical Center, University of Maryland School of Nursing, Baltimore, MD
    • ,
  • Rita Shapiro, DO

      Affiliations

    • VA Chicago Health Care System, Chicago, IL
    • ,
  • Sharon Gordon, PsyD

      Affiliations

    • VA Ann Arbor Health Care System, Ann Arbor, MI
    • ,
  • Joan Stein, APRN, BC

      Affiliations

    • GRECC, Tennessee Valley VA and Center for Health Services Research at Vanderbilt, Nashville, TN
    • ,
  • James L. Rudolph, MD

      Affiliations

    • GRECC, VA Boston Health Care System, Division of Aging, Brigham & Women's Hospital, Department of Medicine, Harvard, Boston, MA
    • ,
  • VA Delirium Working Group

References 

  1. Kiely DK, Bergmann MA, Murphy KM, et al. Delirium among newly admitted postacute facility patients: prevalence, symptoms, and severity. J Gerontol A Biol Sci Med Sci. 2003;58:M441–M445
  2. Lyons WL. Delirium in postacute and long-term care. J Am Med Dir Assoc. 2006;7:254–261
  3. Inouye SK. Delirium in older persons. N Engl J Med. 2006;354:1157–1165
  4. McNicoll L, Pisani MA, Zhang Y, et al. Delirium in the intensive care unit: Occurrence and clinical course in older patients. J Am Geriatr Soc. 2003;51:591–598
  5. Inouye SK, Rushing JT, Foreman MD, et al. Does delirium contribute to poor hospital outcomes? A three-site epidemiologic study. J Gen Intern Med. 1998;13:234–242
  6. McCusker J, Cole M, Dendukuri N, et al. Delirium in older medical inpatients and subsequent cognitive and functional status: a prospective study. CMAJ. 2001;165:575–583
  7. Leslie DL, Marcantonio ER, Zhang Y, et al. One-year health care costs associated with delirium in the elderly population. Arch Intern Med. 2008;168:27–32
  8. Levkoff SE, Marcantonio ER. Delirium: A major diagnostic and therapeutic challenge for clinicians caring for the elderly. Compr Ther. 1994;20:550–557
  9. Inouye SK. Delirium in hospitalized older patients: Recognition and risk factors. J Geriatr Psychiatry Neurol. 1998;11:118–125discussion 57–8
  10. Inouye SK, Foreman MD, Mion LC, et al. Nurses' recognition of delirium and its symptoms: Comparison of nurse and researcher ratings. Arch Intern Med. 2001;161:2467–2473
  11. Inouye SK, Bogardus ST, Charpentier PA, et al. A multicomponent intervention to prevent delirium in hospitalized older patients. N Engl J Med. 1999;340:669–676
  12. Flaherty JH, Tariq SH, Raghavan S, et al. A model for managing delirious older inpatients. J Am Geriatr Soc. 2003;51:1031–1035
  13. Marcantonio ER, Flacker JM, Wright RJ, et al. Reducing delirium after hip fracture: A randomized trial. J Am Geriatr Soc. 2001;49:516–522
  14. Flaherty JH, Rudolph J, Shay K, et al. Delirium is a serious and under-recognized problem: Why assessment of mental status should be the sixth vital sign. J Am Med Dir Assoc. 2007;8:273–275
  15. Boockvar K, Shay K, Edes T, et al. The mental status vital sign. J Am Geriatr Soc. 2008;56:2358–2359
  16. Simon SE, Bergmann MA, Jones RN, et al. Reliability of a structured assessment for nonclinicians to detect delirium among new admissions to postacute care. J Am Med Dir Assoc. 2006;7:412–415
  17. Breitbart W, Rosenfeld B, Roth A, et al. The Memorial Delirium Assessment Scale. J Pain Symptom Manage. 1997;13:128–137
  18. Sessler CN, Gosnell MS, Grap MJ, et al. The Richmond Agitation-Sedation Scale: Validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med. 2002;166:1338–1344
  19. Ely EW, Truman B, Shintani A, et al. Monitoring sedation status over time in ICU patients: Reliability and validity of the Richmond Agitation-Sedation Scale (RASS). JAMA. 2003;289:2983–2991
  20. Ely EW, Margolin R, Francis J, et al. Evaluation of delirium in critically ill patients: Validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit Care Med. 2001;29:1370–1379

PII: S1525-8610(09)00114-5

doi: 10.1016/j.jamda.2009.04.001

JAMDA
Volume 10, Issue 6 , Pages 379-380 , July 2009

Article Tools

* Image Usage & Resolution