ReviewThe American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry2022
Identifying Delirium in Persons With Moderate or Severe Dementia: Review of Challenges and an Illustrative Approach.
Review in The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed.
- Delirium superimposed on dementia in post-acute care: Nurse documentation of symptoms and interventions.Geriatric nursing (New York, N.Y.)Trial
- Passive Smart Home Monitoring for Delirium-Relevant Anomaly Detection in People Living With Dementia: Proof-of-Concept Study.JMIR formative research · 2026Article
- A Comparative Analysis of Psychiatric Consultations Across Emergency, Hospital, and Community Mental Health Settings.Journal of clinical medicine · 2026Article
- Using novel natural language processing approaches to examine age-friendly communication about nursing Nome residents with dementia.The Gerontologist · 2026Article
- Identification of correlative factors and development of a preliminary classification model for delirium superimposed on dementia: a cross-sectional study.Frontiers in psychiatry · 2026Article
- 4AT screening for delirium in dementia: meta-analysis of diagnostic performance.Dementia & neuropsychologia · 2026Review
- Article
- Delirium prevalence and incidence in acutely admitted older patients: an observational cohort study.BMC geriatrics · 2025Observational
- Sundowning Syndrome in Dementia: Mechanisms, Diagnosis, and Treatment.Journal of clinical medicine · 2025Review
- The Relationship between Delirium and Dementia.Seminars in neurology · 2024Review
- Differences in Delirium Evaluation and Pharmacologic Management in Children With Developmental Delay: A Retrospective Case-Control Study.Journal of intensive care medicine · 2024Article
- Electroconvulsive therapy for the acute management of severe agitation in dementia (ECT-AD): A modified study protocol.PloS one · 2024Article
- The Confusion Assessment Method Could Be More Accurate than the Memorial Delirium Assessment Scale for Diagnosing Delirium in Older Cancer Patients: An Exploratory Study.Current oncology (Toronto, Ont.) · 2023Article
- Recognition of Delirium Superimposed on Dementia: Is There an Ideal Tool?Geriatrics (Basel, Switzerland) · 2023Review
- Six-item cognitive impairment test (6-CIT)'s accuracy as a cognitive screening tool: best cut-off levels in emergency department setting.Frontiers in medicine · 2023Article
- Associations Between Dysphagia and Adverse Health Outcomes in Older Adults with Dementia in Intensive Care Units: A Retrospective Cohort Study.Clinical interventions in aging · 2023Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
Delirium and dementia are common causes of cognitive impairment among older adults, which often coexist. Delirium is associated with poor clinical outcomes, and is more frequent and more severe in patients with dementia. Identifying delirium in the presence of dementia, also described as delirium superimposed on dementia (DSD), is particularly challenging, as symptoms of delirium such as inattention, cognitive dysfunction, and altered level of consciousness, are also features of dementia. Because DSD is associated with poorer clinical outcomes than dementia alone, detecting delirium is important for reducing morbidity and mortality in this population. We review a number of delirium screening instruments that have shown promise for use in DSD, including the 4-DSD, combined Six Item Cognitive Impairment Test (6-CIT) and 4 'A's Test (4AT), Confusion Assessment Method (CAM), and the combined UB2 and 3D-CAM (UB-CAM). Each has advantages and disadvantages. We then describe the operationalization of a CAM-based approach in a current ECT in dementia project as an example of modifying an existing instrument for patients with moderate to severe dementia. Ultimately, any instrument modified will need to be validated against a standard clinical reference, in order to fully establish its sensitivity and specificity in the moderate to severe dementia population. Future work is greatly needed to advance the challenging area of accurate identification of delirium in moderate or severe dementia.
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