Observational studyAge and ageing2025
Detecting delirium in Parkinson's disease: an evaluation of diagnostic accuracy of bedside tools.
Observational study in Age and ageing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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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
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prevalence of delirium among patients with advanced cancer: a systematic review and meta-analysis.Frontiers in neurologyPooled it
- Using Wearable Devices to Monitor Activity and Sleep in Inpatients With Parkinson Disease With and Without Delirium: Feasibility and Acceptability Study.Journal of medical Internet research · 2026Article
- Diagnostic test accuracies of 4AT items are consistent across the range of baseline cognition: results from two prospective studies.Age and ageing · 2026Article
- Improving recognition and management of inpatient delirium in Parkinson's disease: evidence review and implications for clinical care.Frontiers in aging neuroscience · 2025Review
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDelirium is a serious, acute neuropsychiatric condition associated with fluctuating attention and altered arousal. Delirium in Parkinson's disease (PD) is common but often missed in hospital due to shared clinical features. This study aimed to evaluate the accuracy of current tools used to identify delirium in inpatients with PD.
methodsPeople with PD admitted to all hospital wards were invited to take part. Participants completed a standardised delirium assessment based on the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) criteria, in addition to standard bedside tools including the 4 As Test (4AT), arousal and cognition. This was a secondary analysis of a prospective observational study; bedside tools were not completed independently of, or blinded to, the DSM-5 criteria. Accuracy was assessed using Receiver Operating Characteristic area under the curve (AUROC).
resultsParticipants included 115 people with PD (200 hospital admissions); 66.1% (n = 76/115) had delirium. Considering all admissions, the diagnostic accuracy of tools was good, ranging from 74% to 89% (AUROC = 0.764-0.923, P < .001 for all). The 4AT scores had the highest sensitivity (96.7%, AUROC = 0.922, P < .001). However, accuracy decreased in those with underlying cognitive impairment (AUROC = 0.499-0.886).
conclusionsCurrent bedside tools can accurately identify delirium in PD inpatients. Although tools were comparable, the 4AT may have greater clinical utility as it had high sensitivity, is quicker to complete and already widely used clinical. However, caution is recommended as tools did not differentiate between symptoms typical in PD and acute symptoms associated with delirium; this should be a focus for future research.
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