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Confusion Assessment Method (CAM)

Portuguese version

Martins, S., Simões, M. R., & Fernandes, L. (2012). Translation process and pilot study of Portuguese Confusion Assessment Method. European Psychiatry, 27(S1), 453. https://doi.org/10.1016/S0924-9338(12)74620-5

Original version

Inouye, S.K., vanDyck, C.H., Alessi, C.A., Balkin, S., Siegal, A.P., & Horwitz, R.I. (1990). Clarifying confusion: The Confusion Assessment Method. A new method for detection of delirium. Annals of Internal Medicine, 113, 941-948. https://doi.org/10.7326/0003-4819-113-12-941

Theoretical background

Delirium (or confusional state of the elderly) is a serious medical condition, particularly common in hospitalized elderly adults. Sometimes unidentified, delirium is related to increased morbidity and mortality in elderly patients (Martins, Simões, & Fernandes, 2012a).

Recommended in numerous guidelines, the Confusion Assessment Method (CAM, Inouye et al., 1990) is a widely used instrument for screening for the detection of delirium.

Description

Assessment Domain: Delirium.

Type of Instrument: Rating scale.

Application: Individual, 5 minutes.

Population: Adult.

Dimensions

The CAM assesses the presence of eight features of delirium: 1. Acute onset and fluctuating course, 2. Inattention, 3. Disorganized thinking, 4. Altered level of consciousness, 5. Disorientation, 6. Memory impairment; 7. Perceptual disturbances, 8. Psychomotor agitation/Psychomotor retardation and 9. Altered sleep-wake cycle.

Studies

The CAM has several studies in the Portuguese population: a translation and adaptation study (Martins, Simões, & Fernandes, 2012b), a pilot study (Martins, Simões, & Fernandes, 2014), and studies that show high interobserver reliability, moderate sensitivity, excellent specificity, good convergent validity with MMSE (Fernandes et al. 2015a; Martins et al., 2015), or a negative relationship between education and delirium (Martins et al., 2017).

The Portuguese investigations with CAM and FAM-CAM were carried out within the scope of the doctoral thesis (Title: Confusion Assessment Method (CAM): Adaptation, validation for the Portuguese population), by Sónia Patrícia Vilar Martins (FCT PhD Scholarship - SFRH /BD/63154/2009/Psychology), student of the Doctoral Program in Gerontology and Geriatrics, at the Abel Salazar Institute of Biomedical Sciences, University of Porto. The use of CAM and FAM-CAM requires prior training and training of interviewers.

References

  1. Fernandes, L., Martins, S., & Simões, M.R. (2015a). Confusion Assessment Method (CAM). In Mário R. Simões, Isabel Santana e Grupo de Estudos de Envelhecimento Cerebral e Demência (Eds.), Escalas e Testes na Demência (3ª. edição; pp. 158-163) [Scales and Tests in Dementia, 3rd edition]. Novartis.
  2. Inouye, S.K., vanDyck, C.H., Alessi, C.A., Balkin, S., Siegal, A.P., & Horwitz, R.I. (1990). Clarifying confusion: The Confusion Assessment Method. A new method for detection of delirium. Annals of Internal Medicine, 113, 941-948. https://doi.org/10.7326/0003-4819-113-12-941
  3. Martins, S., Lourenço, C., Pinto-de-Sousa, J., Conceição, F., Paiva, J. A., Simões, M. R., & Fernandes, L. (2015). Validation study of the European Portuguese version of the Confusion Assessment Method (CAM). International Psychogeriatrics, 27(5), 777-784. https://doi.org/10.1017/S104161021400926
  4. Martins, S., Moldes, P., Pinto-de-Sousa, J., Conceição, F., Paiva, J.A., Simões, M. R., & Fernandes, L. (2014a). Pilot study on the European Portuguese version of the Confusion Assessment Method. Acta Neuropsychiatrica, 26(5), 321-324. https://doi.org/10.1017/neu.2014.15
  5. Martins, S., Paiva, J.A., Simões, M. R., & Fernandes, L. (2017). Delirium in elderly patients: Association with educational attainment. Acta Neuropsychiatrica, 29(2), 95-101. https://doi.org/10.1017/neu.2016.40
  6. Martins, S., Simões, M. R., & Fernandes, L. (2012a). Elderly Delirium Assessment Tools Review. Current Psychiatry Reviews, 8(2), 168-174. https://doi.org/10.2174/1573400511208020168
  7. Martins, S., Simões, M. R., & Fernandes, L. (2012b). Translation process and pilot study of Portuguese Confusion Assessment Method. European Psychiatry, 27(S1), 453. https://doi.org/10.1016/S0924-9338(12)74620-5