Delirium Detection in Hospitalized Older Patients Remains Poor Despite Promising Screening Tools

Strategic Insights -

In a study published in the European Geriatric Medicine journal, researchers from the Department of Geriatric Medicine aimed to investigate the effectiveness of combining the 4AT and SQiD tools for detecting delirium in hospitalized older patients. Despite the promising results of the SQiD tool, which has a high negative predictive value, delirium remains underdiagnosed in hospitalized older patients. The study found that combining the 4AT and SQiD increased the detection rate of possible delirium from 20.3% to 31.3%, but delirium awareness among healthcare professionals remains low, with only 34.9% of nurses and 32.4% of physicians correctly identifying delirious patients.

Key Takeaways:

  • The study aimed to investigate the added value of combining the 4AT and SQiD for detecting delirium in hospitalized older patients.
  • The SQiD tool has a high negative predictive value, but its effectiveness in geriatric patients had not been previously investigated.
  • Combining the 4AT and SQiD tools increased the detection rate of possible delirium from 20.3% to 31.3%.
  • Delirium awareness among healthcare professionals remains low, with only 34.9% of nurses and 32.4% of physicians correctly identifying delirious patients.
  • Orientation deficits and altered alertness were associated with increased odds of staff awareness.
  • The study highlights the need for increased delirium awareness among healthcare professionals to ensure better detection, management, and patient outcomes.

Statistics:

  • 403 patients were included in the study, with a mean age of 81.3 ± 6.3 years and 55.3% female.
  • 75.3% of cases showed consistent results from SQiD alone and the 4AT alone.
  • 20.3% of possible delirium cases were detected using the SQiD tool alone.
  • 31.3% of possible delirium cases were detected using the combined 4AT and SQiD tools.
  • Only 34.9% of nurses correctly identified delirious patients.
  • Only 32.4% of physicians correctly identified delirious patients.

Sources:

  • European Geriatric Medicine. "The Single Question in Delirium as a suitable tool to improve delirium detection in hospitalized older patients." Vol. 2025, 2025.
  • NewsRx. "Reports from Department of Geriatric Medicine Describe Recent Advances in Delirium." Mental Health Weekly Digest, October 20, 2025; p 762.