Comparing performance on the months of the year backwards test in hospitalised patients with delirium, dementia and no cognitive impairment: an exploratory study

Hasemann, W. et al. (2021) Comparing performance on the months of the year backwards test in hospitalised patients with delirium, dementia and no cognitive impairment: an exploratory study. European Geriatric Medicine, 12(6), pp. 1257-1265. (doi: 10.1007/s41999-021-00521-4) (PMID:34156656)

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Abstract

Purpose To investigate performance of the Months of the Year Backwards (MOTYB) test in older hospitalised patients with delirium, dementia, and no cognitive impairment. Methods Secondary analysis of data from a case–control study of 149 hospitalised patients aged ≥ 65 years with delirium [with or without dementia (N = 50)], dementia [without delirium (N = 46)], and no cognitive impairment (N = 53). Verbatim transcripts of MOTYB audio recordings were analysed to determine group differences in response patterns. Results In the total sample [median age 85y (IQR 80–88), 82% female], patients with delirium were more often unable to recite months backward to November (36/50 = 72%) than patients with dementia (21/46 = 46%; p < 0.01) and both differed significantly from patients without cognitive impairment (2/53 = 4%; p’s < 0.001). 121/149 (81%) of patients were able to engage with the test. Patients with delirium were more often unable to engage with MOTYB (23/50 = 46%; e.g., due to reduced arousal) than patients with dementia (5/46 = 11%; p < 0.001); both groups differed significantly (p’s < 0.001) from patients without cognitive impairment (0/53 = 0%). There was no statistically significant difference between patients with delirium (2/27 = 7%) and patients with dementia (8/41 = 20%) in completing MOTYB to January, but performance in both groups differed (p < 0.001 and p < 0.02, respectively) from patients without cognitive impairment (35/53 = 66%). Conclusion Delirium was associated with inability to engage with MOTYB and low rates of completion. In patients able to engage with the test, error-free completion rates were low in delirium and dementia. Recording of engagement and patterns of errors may add useful information to MOTYB scoring.

Item Type:Articles
Additional Information:Funding This work was funded by the Medical Research Council through a Developmental Pathway Funding Scheme, reference MR/L023210/ 1 (PI: AMJM). AMJM, ZT, DJS, AW, CJW, JB, JE, SP, EJW, TQ and TW acquired the funding. AMJM and ZT are members of the University of Edinburgh Centre for Cognitive Ageing and Cognitive Epidemiology which was funded by the BBSRC and MRC as part of the LLHW (MR/K026992/1). CJW was also supported in this work by NHS Lothian via the Edinburgh Clinical Trials Unit. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Quasim, Professor Tara and Evans, Professor Jonathan and Nouzova, Eva and Clarke, Miss Caoimhe and Duncan, Nikki and Tieges, Dr Zoe and Stott J, Professor David
Authors: Hasemann, W., Duncan, N., Clarke, C., Nouzova, E., Süßenbach, L.-M., Keerie, C., Assi, V., Weir, C. J., Evans, J., Walsh, T., Wilson, E., Quasim, T., Middleton, D., Weir, A. J., Barnett, J. H., Stott, D. J., MacLullich, A. M.J., and Tieges, Z.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:European Geriatric Medicine
Publisher:Springer
ISSN:1878-7649
ISSN (Online):1878-7657
Published Online:22 June 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in European Geriatric Medicine 12(6): 1257-1265
Publisher Policy:Reproduced under a Creative Commons License

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