ReviewDementia & neuropsychologia2026
4AT screening for delirium in dementia: meta-analysis of diagnostic performance.
Review in Dementia & neuropsychologia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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
2 citing papers in PubMed.
- Diagnostic test accuracies of 4AT items are consistent across the range of baseline cognition: results from two prospective studies.Age and ageing · 2026Article
- Association between post-intravenous thrombolysis delirium and 90-day functional outcomes in patients with acute ischemic stroke.Frontiers in psychiatry · 2026Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Delirium is frequently underdiagnosed in older adults, especially those with dementia, due to overlapping clinical features. In this meta-analysis, we evaluate the diagnostic performance of the 4 'A's Test (4AT) in detecting delirium specifically among dementia patients. Five eligible diagnostic accuracy studies were identified in a systematic search in six databases, comprising 1,304 older adults, including 482 with dementia. Pooled sensitivity and specificity were 88 and 79%, respectively, with a diagnostic odds ratio of 32.0, indicating strong discriminatory power. The 4AT high sensitivity supports its use as an initial screening tool to rule out delirium in dementia patients, especially in acute or resource-limited settings. However, moderate specificity highlights the need for confirmatory assessments in positive cases. In this review, we underscore the clinical utility of the 4AT for rapid delirium detection in complex geriatric populations and recommend further research on its performance across dementia subtypes and healthcare environments.
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