Observational studyAging clinical and experimental research2023
Diagnostic accuracy of the Dutch version of the 4AT for delirium detection in a mixed patient population and setting.
Observational study in Aging clinical and experimental research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Comparing three approaches to delirium identification in older patients presenting to the emergency department.European geriatric medicine · 2026Article
- Early Diagnosis of Delirium in Geriatric Patients in Emergency Departments: A Systematic Review and Meta-Analysis.Brain sciences · 2026Review
- Review
- Delirium in older adults in the emergency department: a scoping review of current research and identified knowledge gaps.BMC emergency medicine · 2026Article
- 4AT screening for delirium in dementia: meta-analysis of diagnostic performance.Dementia & neuropsychologia · 2026Review
- Diabetes and postoperative cognitive dysfunction and delirium in adults: mechanisms, biomarkers, and clinical management.Frontiers in endocrinology · 2026Review
- Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDelirium is an acute disturbance in attention, awareness and cognition. Immediate detection in older adults is recommended because delirium is associated with adverse outcomes. The 4 'A's Test (4AT) is a short screening instrument for delirium. The aim of this study is to evaluate diagnostic accuracy of the Dutch version of the screening tool 4AT for delirium detection in different settings.
methodsProspective observational study conducted in two hospitals in patients aged ≥ 65 years in geriatric wards and the Emergency Department (ED). Each participant underwent two assessments; the index test 4AT, followed by the reference standard for delirium performed by a geriatric care specialist. The reference standard delirium is according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria.
resultsA total of 71 geriatric inpatients and 49 older ED patients were included. The prevalence of delirium was 11.6% in the acute geriatric ward and 6.1% in the ED. The sensitivity and specificity of the 4AT in the acute geriatric ward were 0.88 and 0.69, respectively. In the ED, the sensitivity and specificity were 0.67 and 0.83, respectively. The area under the receiver operating characteristic curve was 0.80 for the acute geriatric ward setting and 0.74 for the ED setting.
conclusionThe Dutch version of the 4AT is a reliable screening tool for delirium detection in both acute geriatric wards and ED. Due to its brevity and practicality (i.e., no special training is required to administer the tool), it is useful in clinical practice.
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