Validation of the Salzburg Dementia Test Prediction (SDTP) as a Cognitive Screening Tool in an English-Speaking Inpatient Medical Setting.

BACKGROUND: The Salzburg Dementia Test Prediction (SDTP), developed using artificial intelligence and based on the Mini-Mental State Examination (MMSE), was recently introduced as a brief cognitive screening tool for cognitive impairment. OBJECTIVE: In the current study, we investigated whether the STDP can be used as a valid bed-side cognitive screening tool for dementia patients, in an English-speaking, medical inpatient setting. METHODS: 216 medically ill older patients who had completed the MMSE (from which the SDTP scores can be calculated), with a subsample 58 patients who had also completed the ACE-R/ACE-III scales. Diagnosis of one of four dementia types (n = 127) and socio-demographic information were also collected. MMSE, SDTP, ACE-R/ACE-III, and dementia diagnosis were used to examine the construct validity of the SDTP through assessments of the structural, concurrent, and convergent validity. RESULTS: The SDTP shows structural validity through demonstrating uni-dimensionality. Construct validity was demonstrated by sufficient correlation sizes with MMSE scores against a benchmark correlation size for most of the subsample, except vascular dementia. Convergent validity was demonstrated for the STDP with equivalent correlations sizes with ACE-R/ACE-III as the MMSE across all samples, though for vascular dementia the magnitude of this correlation was not as strong. CONCLUSIONS: Our findings support using STDP as a brief assessment tool among patients who have been diagnosed with Alzheimer's disease, Lewy body disease, and mixed dementia; however, there is some statistical variability to overall MMSE scores and correlations with the ACE-R/ACE-III among patients diagnosed with vascular dementia.

Delirium Stigma Among Healthcare Staff.

Older people with delirium occupy more than one third of acute medical beds and require increased medical attention, as care at present is suboptimal. In addition, since delirium is undetected, it should form a target for teaching in wards. Moreover, as people with delirium are largely dependent on daily interactions and care by inpatients professional staff, it is important to address stigmatisation of these vulnerable patients. This is especially important as previous studies have shown that negative staff attitudes towards these patients undermine good care. This single center cross-sectional study was designed to determine the extent of institutional stigma among health professionals involved in the care of people with delirium. For this, professional staff working on medical wards and in communities were approached to fill in a questionnaire containing the adapted Delirium Stigma Scale and the EuroQol five dimensions (EQ-5D-5L) questionnaire. Additional demographic information concerning their education and professional and personal experience with delirium was also collected. The characteristics associated with stigma were determined from the sample. The findings of our study provide an insight into the high level of stigmatisation of delirium patients among professionals (mean 11.66/18 points). This was not related to professionals' own experiences of delirium, their educational and professional backgrounds, or them having received formal delirium education. However, working closely with people with delirium seems to have a positive impact on the de-stigmatisation of this population among health professionals. Our findings that attitudes are not influenced by formal delirium teaching need to be incorporated into the design of interprofessional educational interventions. Accordingly, we advocate more direct patient-oriented and care delivered teaching interventions.