|Delirium: Advances in Research and Clinical Practice|
Diagnostic Criteria and Assessment Instruments
The High Sensitivity Cognitive Screen
|Barry S. Fogel a1|
a1 Department of Psychiatry and Human Behavior, Center for Gerontology and Health Care Research, Brown University, Providence, Rhode Island, U.S.A.
Ceiling effects limit the utility of many established brief cognitive screening tests for detecting and measuring mild delirious states and prodromal disorders. The High Sensitivity Cognitive Screen (HSCS) (Faust & Fogel, 1989), a bedside test taking approximately 25 minutes to administer, may overcome this limitation. The test consists of a selection of moderately difficult items testing six major domains of neuropsychological performance: memory, language, attention/concentration, visual/motor, spatial, and self-regulation and planning. Reliability is adequate, and two separate concurrent validity studies show accuracy rates of 93% and 87% in classifying the overall result of comprehensive neuropsychological testing. HSCS performance is highly correlated with EEG results in medical psychiatric inpatients, and with functional status in HIV-infected community-dwelling subjects. The brevity and convenience of the HSCS and related instruments make them particularly useful in studies of elderly and chronically ill subjects.