Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec;12(6):1257-1265.
doi: 10.1007/s41999-021-00521-4. Epub 2021 Jun 22.

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  1   2 , Nikki Duncan  3   4 , Caoimhe Clarke  3   4 , Eva Nouzova  3 , Lisa-Marie Süßenbach  3 , Catriona Keerie  5 , Valentina Assi  5 , Christopher J Weir  5 , Jonathan Evans  6 , Tim Walsh  7 , Elizabeth Wilson  8 , Tara Quasim  9 , Duncan Middleton  10 , Alexander J Weir  10 , Jennifer H Barnett  11 , David J Stott  4 , Alasdair M J MacLullich  3 , Zoë Tieges  3   12
Affiliations

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 et al. Eur Geriatr Med. 2021 Dec.

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.

Keywords: Attention; Case–control studies; Cognitive dysfunction; Delirium; Dementia.

PubMed Disclaimer

Conflict of interest statement

All authors declare that they have no conflict of interest with this study.

Figures

Fig. 1
Fig. 1
Last correct month in MOTYB in 149 patients. 2 patients without cognitive impairment, 14 with dementia and 10 with delirium (with and without dementia) stated December as the last correct month in MOTYB. Additionally, out of 50 patients with delirium, 26 could not state December as the last correct month. Of those 3 were able and 23 were unable to meaningfully engage with MOTYB. Out of 46 patients with dementia (without delirium), 7 could not state December as the last correct month. Of those, 2 were able and 5 were unable to meaningfully engage with MOTYB
Fig. 2
Fig. 2
Flow chart synthesising the clinical approach from Fig 1 and Tables 2–4
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Meagher D, Leonard M. The active management of delirium: improving detection and treatment. Adv Psychiatr Treat. 2018;14(4):292–301. doi: 10.1192/apt.bp.107.003723. - DOI
    1. Blessed G, Tomlinson BE, Roth M. The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. Br J Psychiatry. 1968;114(512):797–811. doi: 10.1192/bjp.114.512.797. - DOI - PubMed
    1. Rudolph JL, Jones RN, Grande LJ, Milberg WP, King EG, Lipsitz LA, et al. Impaired executive function is associated with delirium after coronary artery bypass graft surgery. J Am Geriatr Soc. 2006;54(6):937–941. doi: 10.1111/j.1532-5415.2006.00735.x. - DOI - PMC - PubMed
    1. Grober E, Hall CB, Hahn SR, Lipton RB. Memory impairment and executive dysfunction are associated with inadequately controlled diabetes in older adults. J Prim Care Community Health. 2011;2(4):229–233. doi: 10.1177/2150131911409945. - DOI - PMC - PubMed
    1. Ball LJ, Bisher GB, Birge SJ. A simple test of central processing speed: an extension of the Short Blessed Test. J Am Geriatr Soc. 1999;47(11):1359–1363. doi: 10.1111/j.1532-5415.1999.tb07440.x. - DOI - PubMed

Publication types