Risk factors, preventive interventions, overlapping symptoms, and clinical measures of delirium in elderly patients

Table 1 Incidence and prevalence of delirium

Country or region/manuscript type	Medical scenario	Assessment method	Incidence (%)	Prevalence (%)
United States[1]	Community	NR	NR	1-2
Italy[79]	Community	DSM-5	NR	3.6
Spain[80]	Community	DSM-4	NR	0.96
Jordan[81]	Postcardiac surgery	CAM-ICU	9	NR
Poland[82]	Postcardiac surgery	DSM-5 (age ≥ 65 yr)	21.4	NR
		DSM-5 (age ≥ 80 yr)	33.5	NR
Czech[83]	ICU	CAM-ICU	26.1	NR
Systematic review[84]	ICU	Hyperactive	4	4
		Hypoactive	11	17
		Mixed	7	10
Canada[85]	Dementia Ward	CAM (MMSE ≥ 10)	1.6	3.4
		CAM (MMSE < 10)	6.9	33.3
Italy[86]	Dementia Clinic	CAM	NR	13.3
Australia[87]	Hospice care	DSM-5	40.2-45	42-88
Systematic review[88]	Hospice care	NA	29	35
Australia[89]	Post-stroke (3 d)	DSM-4	25	NR
Portugal[90]	Post-stroke (1 d)	DRS	2	NR
Systematic review[25]	Post-stroke	NA	NR	13-48
Holland[91]	Psychiatric Outpatient Clinic	DRS-R98 (probable)	NR	19
		DRS-R98	NR	2

NR: Not reported; NA: Not available; ICU: Intensive care unit; DSM: Diagnostic and Statistical Manual of Mental Disorders; DRS: Delirium Rating Scale; CAM: Confusion Assessment Method.

Table 2 Common delirium assessment scales

Name	Time (min)	Application	Sensitivity (%)	Specificity (%)	Rigorous training	Suitable for examining DSD
Confusion Assessment Method (CAM)[92,93]	3-10	No ICU	46-94	63-100	Yes	Yes
The 4A’s test (4AT)[94]	< 2	No ICU	86-100	65-82	No	Yes
The 12-item Stanford Proxy Test for Delirium (S-PTD)[95]	5	No ICU	80	90	No	No
Richmond Agitation Screening Scale (RASS)[96,97]	1	Delirium has just started	65-75	82-90	No	Yes
The Recognizing Acute Delirium As part of your Routine (RADAR)[98]	< 1	Delirium has just started	73	67	No	Yes
Confusion Assessment Method for ICU (CAM-ICU)[99]	< 5	ICU	28-100	53-99	Yes	Yes
Intensive Care Delirium Screening Checklist (ICDSC)[100]	7-10	ICU	73-97	69-97	Yes	No
Delirium Triage Screen (DTS)[101]	< 1	Screening	82	96.1	No	No
Ultra Brief 2 Item Screener (UB-2)[102,103]	< 1	Screening	93	64	No	No
Simple Question for Easy Evaluation of Consciousness (SQEEC)[104]	< 1	Screening	93	81	No	No
Delirium Rating Scale revised-98 (DRS-R98)[105]	20	Detailed neuropsychological assessment	57-93	82-98	Yes	Yes
Memorial Delirium Assessment Scale (MDAS)[106]	7-10	Detailed neuropsychological assessment	64-82	75-100	Yes	No
CAM Severity (CAM-S)[107]	5	Detailed neuropsychological assessment	NR	NR	No	No

NR: Not reported; ICU: Intensive care unit; DSD: Delirium superimposed dementia.