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Dysgraphia in elderly delirious medical inpatients.
Aging Clin Exp Res 2006; 18(4):334-9AC

Abstract

BACKGROUND AND AIMS

Dysgraphia is a recognized clinical finding in delirium, but few studies have evaluated handwriting, and results have been inconsistent. In particular, handwritten signatures, which may be a motor automatism, have not been previously evaluated in delirious patients. The aim was to assess abnormalities of signature and spontaneous writing in delirious patients and to investigate their clinical utility in the detection of delirium.

METHODS

Secondary analysis of data was collected from a prospective observational study of acutely ill inpatients 70 years or older. Mini-Mental State Examination, Confusion Assessment Method, Delirium Rating Scale, Activities of Daily Living, and APACHE II were administered to each subject, their signatures were evaluated from the consent form, and their handwriting from the spontaneous sentence written as part of the MMSE.

RESULTS

The signatures of patients with delirium were significantly more impaired than those without (Chi-square= 14.749, df=1, p<0.0001). The sensitivity of the signature for delirium as defined by CAM was 0.54, with specificity of 0.88. Handwriting abnormalities of omission (p=0.018), illegibility (p=0.034) and spelling (p=0.035) were significantly more common in delirious patients than others (Chi-square with Fisher's Exact tests. This difference was mainly attributable to the fact that a large number of delirious patients were unable to provide any response to the handwriting questions.

CONCLUSIONS

An abnormal signature may be an indicator of delirium. People with delirium have handwriting problems, which may be partly caused by cognitive impairment but also by disorders of motor function.

Authors+Show Affiliations

Department of Ageing and Health, Guy's and St Thomas' NHS Foundation Trust, London, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Studies
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17063069

Citation

Adamis, Dimitrios, et al. "Dysgraphia in Elderly Delirious Medical Inpatients." Aging Clinical and Experimental Research, vol. 18, no. 4, 2006, pp. 334-9.
Adamis D, Reich S, Treloar A, et al. Dysgraphia in elderly delirious medical inpatients. Aging Clin Exp Res. 2006;18(4):334-9.
Adamis, D., Reich, S., Treloar, A., Macdonald, A. J., & Martin, F. C. (2006). Dysgraphia in elderly delirious medical inpatients. Aging Clinical and Experimental Research, 18(4), pp. 334-9.
Adamis D, et al. Dysgraphia in Elderly Delirious Medical Inpatients. Aging Clin Exp Res. 2006;18(4):334-9. PubMed PMID: 17063069.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dysgraphia in elderly delirious medical inpatients. AU - Adamis,Dimitrios, AU - Reich,Shuli, AU - Treloar,Adrian, AU - Macdonald,Alastair J, AU - Martin,Finbarr C, PY - 2006/10/26/pubmed PY - 2006/12/13/medline PY - 2006/10/26/entrez SP - 334 EP - 9 JF - Aging clinical and experimental research JO - Aging Clin Exp Res VL - 18 IS - 4 N2 - BACKGROUND AND AIMS: Dysgraphia is a recognized clinical finding in delirium, but few studies have evaluated handwriting, and results have been inconsistent. In particular, handwritten signatures, which may be a motor automatism, have not been previously evaluated in delirious patients. The aim was to assess abnormalities of signature and spontaneous writing in delirious patients and to investigate their clinical utility in the detection of delirium. METHODS: Secondary analysis of data was collected from a prospective observational study of acutely ill inpatients 70 years or older. Mini-Mental State Examination, Confusion Assessment Method, Delirium Rating Scale, Activities of Daily Living, and APACHE II were administered to each subject, their signatures were evaluated from the consent form, and their handwriting from the spontaneous sentence written as part of the MMSE. RESULTS: The signatures of patients with delirium were significantly more impaired than those without (Chi-square= 14.749, df=1, p<0.0001). The sensitivity of the signature for delirium as defined by CAM was 0.54, with specificity of 0.88. Handwriting abnormalities of omission (p=0.018), illegibility (p=0.034) and spelling (p=0.035) were significantly more common in delirious patients than others (Chi-square with Fisher's Exact tests. This difference was mainly attributable to the fact that a large number of delirious patients were unable to provide any response to the handwriting questions. CONCLUSIONS: An abnormal signature may be an indicator of delirium. People with delirium have handwriting problems, which may be partly caused by cognitive impairment but also by disorders of motor function. SN - 1594-0667 UR - https://www.unboundmedicine.com/medline/citation/17063069/Dysgraphia_in_elderly_delirious_medical_inpatients_ L2 - https://medlineplus.gov/delirium.html DB - PRIME DP - Unbound Medicine ER -