John Libbey Eurotext

Gériatrie et Psychologie Neuropsychiatrie du Vieillissement


Le repérage et le diagnostic de l’état confusionnel aigu chez les personnes âgées : quels outils rapides ? Volume 20, issue 1, Mars 2022



1 Centre mémoire de ressources et de recherche (CMRR) de Lyon, Institut du vieillissement, Hospices de Lyon, France
2 Département de gériatrie, Centre hospitalo-universitaire de Strasbourg, France
3 Service universitaire de médecine gériatrique, hospices civils de Lyon, Groupement hospitalier Sud, Pierre-Bénite, France
4 Research on Healthcare Professionals and Performance (RESHAPE) Inserm U1290, Université de Lyon, France
5 Pôle de gérontologie clinique, CHU de Nantes, France
6 Service de gériatrie, Centre hospitalier et universitaire de Besançon, France
7 Équipe « Éthique et progrès médical », Inserm CIC 1431, Centre hospitalier et universitaire de Besançon, France
8 Laboratoire de recherches intégratives en neurosciences et psychologie cognitive, Université de Franche-Comté, UFR des sciences de la santé, Besançon, France
9 Centre de recherche, Institut Universitaire de Gériatrie, Montréal, QC, Canada
10 Centre de recherche en neurosciences de Lyon (CRNL), Inserm 1048, CNRS 5292, Université de Lyon, France
* Correspondance : A. Garnier-Crussard

Delirium is very common in hospitalized older patients and associated with serious clinical outcomes, notably increased risk of functional decline and death. Despite its high prevalence in the hospital setting, delirium is still underdiagnosed. A better identification would allow an early management and a reduction of its complications. To achieve this, the validation of formalized, easy-to-use and quick tools for the identification of delirium and their implementation in our clinical practice are necessary.

The objective of this narrative review is to describe the available tools for delirium identification most commonly used in clinical practice and in research, followed by those that are quick to very quick to complete (i.e., less than 3 minutes).

This review identified 4 tools frequently used internationally (CAM, DRS-R-98, DOSS, MDAS). Their completion time varies from 5 to 30 minutes. Rapid or very rapid tools exist, with very good diagnostic performance. Among them, the 4AT, the 3D-CAM and the UB-CAM seem particularly promising. These last tools seem interesting for a large-scale implementation at the national level, but a validation in French remains to be done.