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

Wolfgang Hasemann*, Nikki Duncan, Caoimhe Clarke, Eva Nouzova, Lisa-Marie Sussenbach, Catriona Keerie, Valentina Assi, Christopher J. Weir, Jonathan Evans, Tim Walsh, Elizabeth Wilson, Tara Quasim, Duncan Middleton, Alexander J. Weir, Jennifer H. Barnett, David J. Stott, Alasdair M.J. MacLullich, Zoe Tieges

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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.
Original languageEnglish
JournalEuropean Geriatric Medicine
Publication statusAccepted/In press - 19 May 2021

Keywords

  • attention, cognitive dysfunction, delirium, dementia, case-control studies

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