Application of a perioperative nursing strategy in the surgical treatment of elderly patients: a narrative review†

Scale	Sensitivity (%)	Specificity (%)	Characteristics and applicable groups
CAM²²	76.0	100	Based on DSM-3R; has been verified in the Chinese population; suitable for elderly patients who are hospitalized²³
CAM-ICU²⁴	81.8–93.4	87.7–90.8	Based on DSM-IV; has been verified in the Chinese population; suitable for patients with endotracheal intubation and patients who are in intensive care units or emergency departments²⁵
3D-CAM	95.0	94.0	Based on CAM and provides the standardized evaluation method; has not been verified in the Chinese population; suitable for older people and patients with dementia²⁶

Scale	Sensitivity (%)	Specificity (%)	Assessment time (min)
MMSE¹²	63.4	65.4	5–10
ACE-R¹³	91.9	76.3	10–20
MoCA¹⁴	80–100	50–70	10–15

Scale	Features
HAMA¹⁶	This assessment takes 15–20 min and is the most commonly used scale to assess the severity of anxiety. The total score is 56 points: scores of 14 and above indicate anxiety, and scores of ≥29 indicate severe anxiety. It is conducted by trained professionals.
GAD-7¹⁷	This assessment takes 5 min and is mainly used for generalized anxiety screening. The total score is 21 points: 0–4 is normal, 5–9 indicates mild anxiety, 10–14 indicates moderate anxiety, and ≥15 indicates severe anxiety.
GDS¹⁸	This assessment is used for depression screening and takes 5–15 min. There are 30-, 15-, 10-, and 6-item versions. The highest score on the 30-item scale is 30: 0–10 is normal, 11–20 indicates mild depression, and 21–30 indicates moderate and severe depression. This test is suitable for older people.
HAMD¹⁹	This tool assesses the severity of depression and takes 15 min. It is the gold standard of depression assessment scales and is conducted by trained professionals. The scale has 3 versions of 17, 21, and 24 items. When using the 17-item table, the highest score is 56 points: 0–7 is normal, 8–14 indicates mild depression, 15–23 indicates moderate depression, and ≥24 indicates severe depression.

Application of a perioperative nursing strategy in the surgical treatment of elderly patients: a narrative review^†