{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:42:05Z","timestamp":1787067725156,"version":"build-2736575974"},"reference-count":81,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100014840","name":"Gemeinsame Bundesausschuss","doi-asserted-by":"publisher","award":["01VSF20003"],"award-info":[{"award-number":["01VSF20003"]}],"id":[{"id":"10.13039\/501100014840","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Deutsches Zentrum f\u00fcr Neurodegenerative Erkrankungen e.V. (DZNE) in der Helmholtz-Gemeinschaft"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Geriatr Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Delirium is a common geriatric syndrome that presents as an acute change in mental status and is associated with adverse outcomes. The primary aim of this systematic review and meta-analysis was to determine its prevalence in the nursing home population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>MEDLINE, CINAHL, PsycInfo, and Web of Science were searched up to July 11, 2025. Eligible studies reported cross-sectional prevalence data on delirium in the nursing home population, identified using formal diagnostic criteria (DSM-III or ICD-10 onwards) or validated detection tools. Two reviewers independently screened records, extracted data, and assessed quality. A random-effects meta-analysis was conducted to pool the overall prevalence. The reporting adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of nine studies were included, and prevalence data on delirium from eight distinct study populations were analyzed. The prevalence of delirium ranged from 1.0% to 57.9%. The pooled prevalence, encompassing 4291 nursing home residents aged \u2265\u200965\u00a0years, was 18.8% (95% CI: 7.4%\u201340.2%; I2\u2009=\u200996.9%; Wald-Chi2-Test\u2009=\u2009227.66,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Dementia was present in up to 86.2% of residents. Four studies reported factors associated with the prevalence of delirium, with cognitive impairment most frequently identified as a factor in all four studies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Delirium was identified as a common health issue in most of the included studies, although prevalence rates were heterogeneous. Future research should prioritize the development of effective detection and prevention strategies, the validation of tools tailored to the nursing home setting, and the conduct of robust, internationally comparable prevalence assessments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s41999-026-01422-0","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T16:27:15Z","timestamp":1771518435000},"page":"1357-1376","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Prevalence of delirium among older nursing home residents: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1269-2074","authenticated-orcid":false,"given":"Alexandre","family":"Houdelet-Oertel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0404-6095","authenticated-orcid":false,"given":"Romy","family":"Lauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0108-4459","authenticated-orcid":false,"given":"Vincent","family":"Molitor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3350-8754","authenticated-orcid":false,"given":"Roberto","family":"Walter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7631-9881","authenticated-orcid":false,"given":"Jonas","family":"D\u00f6rner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4910-8413","authenticated-orcid":false,"given":"Rebecca","family":"Palm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0280-0899","authenticated-orcid":false,"given":"Ina","family":"Otte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0117-7188","authenticated-orcid":false,"given":"Horst Christian","family":"Vollmar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2549-7765","authenticated-orcid":false,"given":"Bernhard","family":"Holle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"key":"1422_CR1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (APA) (2022) Diagnostic and statistical manual of mental disorders. 5th text rev. edn. American Psychiatric Association, Washington","DOI":"10.1176\/appi.books.9780890425787"},{"key":"1422_CR2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.49950","volume":"6","author":"CH Ormseth","year":"2023","unstructured":"Ormseth CH, LaHue SC, Oldham MA, Josephson SA, Whitaker E, Douglas VC (2023) Predisposing and precipitating factors associated with delirium: a systematic review. JAMA Netw Open 6:e2249950","journal-title":"JAMA Netw Open"},{"key":"1422_CR3","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1176\/appi.neuropsych.18020024","volume":"30","author":"PT Trzepacz","year":"2018","unstructured":"Trzepacz PT, Franco JG, Meagher DJ, Lee Y, Kim J-L, Kishi Y et al (2018) Delirium phenotype by age and sex in a pooled data set of adult patients. J Neuropsychiatry Clin Neurosci 30:294\u2013301","journal-title":"J Neuropsychiatry Clin Neurosci"},{"key":"1422_CR4","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1016\/j.psym.2012.06.010","volume":"54","author":"JG Franco","year":"2013","unstructured":"Franco JG, Trzepacz PT, Meagher DJ, Kean J, Lee Y, Kim J-L et al (2013) Three core domains of delirium validated using exploratory and confirmatory factor analyses. Psychosomatics 54:227\u2013238","journal-title":"Psychosomatics"},{"key":"1422_CR5","doi-asserted-by":"publisher","first-page":"e122","DOI":"10.1176\/appi.neuropsych.13110345","volume":"27","author":"S Thurber","year":"2015","unstructured":"Thurber S, Kishi Y, Trzepacz PT, Franco JG, Meagher DJ, Lee Y et al (2015) Confirmatory factor analysis of the delirium rating scale revised-98 (DRS-R98). J Neuropsychiatry Clin Neurosci 27:e122\u2013e127","journal-title":"J Neuropsychiatry Clin Neurosci"},{"key":"1422_CR6","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1176\/appi.psy.50.3.255","volume":"50","author":"JG Franco","year":"2009","unstructured":"Franco JG, Trzepacz PT, Mej\u00eda MA, Ochoa SB (2009) Factor analysis of the Colombian translation of the Delirium Rating Scale (DRS), revised\u201398. Psychosomatics 50:255\u2013262","journal-title":"Psychosomatics"},{"key":"1422_CR7","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/j.genhosppsych.2021.03.010","volume":"70","author":"E Sep\u00falveda","year":"2021","unstructured":"Sep\u00falveda E, Berm\u00fadez E, Gonz\u00e1lez D, Cotino P, Vi\u00f1uelas E, Palma J et al (2021) Validation of the Delirium Diagnostic Tool-Provisional (DDT-Pro) in a skilled nursing facility and comparison to the 4 \u2018A\u2019s test (4AT). Gen Hosp Psychiatry 70:116\u2013123","journal-title":"Gen Hosp Psychiatry"},{"key":"1422_CR8","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1001\/jama.2010.1013","volume":"304","author":"J Witlox","year":"2010","unstructured":"Witlox J, Eurelings LS, de Jonghe JF, Kalisvaart KJ, Eikelenboom P, Van Gool WA (2010) Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: a meta-analysis. JAMA 304:443\u2013451","journal-title":"JAMA"},{"key":"1422_CR9","doi-asserted-by":"publisher","first-page":"1373","DOI":"10.1001\/jamaneurol.2020.2273","volume":"77","author":"TE Goldberg","year":"2020","unstructured":"Goldberg TE, Chen C, Wang Y, Jung E, Swanson A, Ing C et al (2020) Association of delirium with long-term cognitive decline: a meta-analysis. JAMA Neurol 77:1373\u20131381","journal-title":"JAMA Neurol"},{"key":"1422_CR10","doi-asserted-by":"publisher","first-page":"2809","DOI":"10.1093\/brain\/aws190","volume":"135","author":"DH Davis","year":"2012","unstructured":"Davis DH, Muniz Terrera G, Keage H, Rahkonen T, Oinas M, Matthews FE et al (2012) Delirium is a strong risk factor for dementia in the oldest-old: a population-based cohort study. Brain 135:2809\u20132816","journal-title":"Brain"},{"key":"1422_CR11","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1007\/s41999-019-00276-z","volume":"11","author":"ST Williams","year":"2020","unstructured":"Williams ST, Dhesi JK, Partridge JS (2020) Distress in delirium: causes, assessment and management. Eur Geriatr Med 11:63\u201370","journal-title":"Eur Geriatr Med"},{"key":"1422_CR12","doi-asserted-by":"publisher","first-page":"2467","DOI":"10.1001\/archinte.161.20.2467","volume":"161","author":"SK Inouye","year":"2001","unstructured":"Inouye SK, Foreman MD, Mion LC, Katz KH, Cooney JLM (2001) Nurses\u2019 recognition of delirium and its symptoms: comparison of nurse and researcher ratings. Arch Intern Med 161:2467\u20132473","journal-title":"Arch Intern Med"},{"key":"1422_CR13","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6955-7-4","volume":"7","author":"P Voyer","year":"2008","unstructured":"Voyer P, Richard S, Doucet L, Danjou C, Carmichael P-H (2008) Detection of delirium by nurses among long-term care residents with dementia. BMC Nurs 7:4","journal-title":"BMC Nurs"},{"key":"1422_CR14","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1111\/j.1365-2648.2005.03557.x","volume":"52","author":"K Milisen","year":"2005","unstructured":"Milisen K, Lemiengre J, Braes T, Foreman MD (2005) Multicomponent intervention strategies for managing delirium in hospitalized older people: systematic review. J Adv Nurs 52:79\u201390","journal-title":"J Adv Nurs"},{"key":"1422_CR15","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1111\/j.1532-5415.2005.53210.x","volume":"53","author":"M Lundstr\u00f6m","year":"2005","unstructured":"Lundstr\u00f6m M, Edlund A, Karlsson S, Br\u00e4nnstr\u00f6m B, Bucht G, Gustafson Y (2005) A multifactorial intervention program reduces the duration of delirium, length of hospitalization, and mortality in delirious patients. J Am Geriatr Soc 53:622\u2013628","journal-title":"J Am Geriatr Soc"},{"key":"1422_CR16","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1186\/s12877-018-0733-3","volume":"18","author":"ENM Cheung","year":"2018","unstructured":"Cheung ENM, Benjamin S, Heckman G, Ho JM, Lee L, Sinha SK et al (2018) Clinical characteristics associated with the onset of delirium among long-term nursing home residents. BMC Geriatr 18:39","journal-title":"BMC Geriatr"},{"key":"1422_CR17","doi-asserted-by":"publisher","first-page":"376","DOI":"10.4414\/smw.2010.12964","volume":"140","author":"A von Gunten","year":"2010","unstructured":"von Gunten A, Mosimann UP (2010) Delirium upon admission to Swiss nursing homes: a cross-sectional study. Swiss Med Wkly 140:376\u2013381","journal-title":"Swiss Med Wkly"},{"key":"1422_CR18","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1002\/gps.2770","volume":"27","author":"M Boorsma","year":"2012","unstructured":"Boorsma M, Joling KJ, Frijters DH, Ribbe ME, Nijpels G, van Hout HP (2012) The prevalence, incidence and risk factors for delirium in Dutch nursing homes and residential care homes. Int J Geriatr Psychiatry 27:709\u2013715","journal-title":"Int J Geriatr Psychiatry"},{"key":"1422_CR19","doi-asserted-by":"publisher","first-page":"1544","DOI":"10.3390\/healthcare10081544","volume":"10","author":"K Komici","year":"2022","unstructured":"Komici K, Guerra G, Addona F, Fantini C (2022) Delirium in nursing home residents: a narrative review. Healthcare (Basel) 10:1544","journal-title":"Healthcare (Basel)"},{"key":"1422_CR20","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1002\/gps.3814","volume":"28","author":"E de Lange","year":"2013","unstructured":"de Lange E, Verhaak PF, van der Meer K (2013) Prevalence, presentation and prognosis of delirium in older people in the population, at home and in long term care: a review. Int J Geriatr Psychiatry 28:127\u2013134","journal-title":"Int J Geriatr Psychiatry"},{"key":"1422_CR21","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71","volume":"372","author":"MJ Page","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71","journal-title":"BMJ"},{"key":"1422_CR22","first-page":"147","volume":"13","author":"Z Munn","year":"2015","unstructured":"Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C (2015) Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data. JBI Evid Implement 13:147\u2013153","journal-title":"JBI Evid Implement"},{"key":"1422_CR23","unstructured":"American Psychiatric Association (APA) (1980) Diagnostic and Statistical Manual of Mental Disorders. 3th edn. American Psychiatric Association, Washington"},{"key":"1422_CR24","volume-title":"The ICD-10 Classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines","author":"World Health Organization (WHO)","year":"1992","unstructured":"World Health Organization (WHO) (1992) The ICD-10 Classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. World Health Organization, Geneva"},{"key":"1422_CR25","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1016\/j.jamda.2014.12.013","volume":"16","author":"AM Sanford","year":"2015","unstructured":"Sanford AM, Orrell M, Tolson D, Abbatecola AM, Arai H, Bauer JM et al (2015) An international definition for \u201cNursing Home.\u201d J Am Med Dir Assoc 16:181\u2013184","journal-title":"J Am Med Dir Assoc"},{"key":"1422_CR26","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1590\/0047-2085000000298","volume":"70","author":"DF Fagundes","year":"2021","unstructured":"Fagundes DF, Costa MT, Alves BBdS, Ben\u00edcio MMS, Vieira LP, Carneiro LS et al (2021) Prevalence of dementia in long-term care institutions: a meta-analysis. J Bras Psiquiatr 70:59\u201367","journal-title":"J Bras Psiquiatr"},{"key":"1422_CR27","volume-title":"JBI manual for evidence synthesis","author":"SMZ Moola","year":"2020","unstructured":"Moola SMZ, Tufanaru C, Aromataris E, Sears K, Sfetcu R, Currie M, Qureshi R, Mattis P, Lisy K, Mu P-F (2020) Systematic reviews of etiology and risk. In: Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z (eds) JBI manual for evidence synthesis. JBI"},{"key":"1422_CR28","doi-asserted-by":"crossref","unstructured":"Borenstein M, Hedges L, Higgins J, Rothstein H (2009) Chapter 16: identifying and quantifying heterogeneity. Introduction to meta-analysis. John Wiley & Sons, Chichester (UK), pp 107\u2013125","DOI":"10.1002\/9780470743386"},{"key":"1422_CR29","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","volume":"315","author":"M Egger","year":"1997","unstructured":"Egger M, Smith GD, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629\u2013634","journal-title":"BMJ"},{"key":"1422_CR30","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1007\/s40520-018-0974-1","volume":"31","author":"M Bo","year":"2019","unstructured":"Bo M, Porrino P, Di Santo SG, Mazzone A, Cherubini A, Mossello E et al (2019) The association of indwelling urinary catheter with delirium in hospitalized patients and nursing home residents: an explorative analysis from the \u201cDelirium Day 2015.\u201d Aging Clin Exp Res 31:411\u2013420","journal-title":"Aging Clin Exp Res"},{"key":"1422_CR31","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1159\/000490722","volume":"46","author":"V Morichi","year":"2018","unstructured":"Morichi V, Fedecostante M, Morandi A, Di Santo SG, Mazzone A, Mossello E et al (2018) A point prevalence study of delirium in Italian nursing homes. Dement Geriatr Cogn Disord 46:27\u201341","journal-title":"Dement Geriatr Cogn Disord"},{"key":"1422_CR32","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1159\/000071004","volume":"16","author":"JV Laurila","year":"2003","unstructured":"Laurila JV, Pitkala KH, Strandberg TE, Tilvis RS (2003) The impact of different diagnostic criteria on prevalence rates for delirium. Dement Geriatr Cogn Disord 16:156\u2013162","journal-title":"Dement Geriatr Cogn Disord"},{"key":"1422_CR33","doi-asserted-by":"publisher","first-page":"1152","DOI":"10.1002\/gps.2654","volume":"26","author":"J McCusker","year":"2011","unstructured":"McCusker J, Cole MG, Voyer P, Monette J, Champoux N, Ciampi A et al (2011) Prevalence and incidence of delirium in long-term care. Int J Geriatr Psychiatry 26:1152\u20131161","journal-title":"Int J Geriatr Psychiatry"},{"key":"1422_CR34","doi-asserted-by":"publisher","first-page":"1162","DOI":"10.1016\/j.jamda.2020.09.032","volume":"22","author":"A Morandi","year":"2021","unstructured":"Morandi A, Inzitari M, Udina C, Gual N, Mota M, Tassistro E et al (2021) Visual and hearing impairment are associated with delirium in hospitalized patients: results of a multisite prevalence study. J Am Med Dir Assoc 22:1162-1167.e3","journal-title":"J Am Med Dir Assoc"},{"key":"1422_CR35","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1159\/000082888","volume":"19","author":"KH Pitkala","year":"2005","unstructured":"Pitkala KH, Laurila JV, Strandberg TE, Tilvis RS (2005) Prognostic significance of delirium in frail older people. Dement Geriatr Cogn Disord 19:158\u2013163","journal-title":"Dement Geriatr Cogn Disord"},{"key":"1422_CR36","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1186\/s12877-021-02517-y","volume":"21","author":"K Sabbe","year":"2021","unstructured":"Sabbe K, van der Mast R, Dilles T, Van Rompaey B (2021) The prevalence of delirium in belgian nursing homes: a cross-sectional evaluation. BMC Geriatr 21:634","journal-title":"BMC Geriatr"},{"key":"1422_CR37","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1177\/14034948980260011201","volume":"26","author":"O Sandberg","year":"1998","unstructured":"Sandberg O, Gustafson Y, Br\u00e4nnstr\u00f6m B, Bucht G (1998) Prevalence of dementia, delirium and psychiatric symptoms in various care settings for the elderly. Scand J Soc Med 26:56\u201362","journal-title":"Scand J Soc Med"},{"key":"1422_CR38","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1093\/ageing\/afx155","volume":"47","author":"EA Teale","year":"2018","unstructured":"Teale EA, Munyombwe T, Schuurmans M, Siddiqi N, Young J (2018) A prospective observational study to investigate utility of the Delirium Observational Screening Scale (DOSS) to detect delirium in care home residents. Age Ageing 47:56\u201361","journal-title":"Age Ageing"},{"key":"1422_CR39","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-024-05360-z","volume":"24","author":"M Fedecostante","year":"2024","unstructured":"Fedecostante M, Balietti P, Di Santo SG, Zambon A, Marengoni A, Morandi A et al (2024) Delirium in nursing home residents: is there a role of antidepressants? A cross sectional study. BMC Geriatr 24:767","journal-title":"BMC Geriatr"},{"key":"1422_CR40","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1111\/ggi.14878","volume":"24","author":"K Sabbe","year":"2024","unstructured":"Sabbe K, van der Mast R, Dilles T, Van Rompaey B (2024) Validation of the Delirium Observation Screening Scale in long-term care facilities in Flanders. Geriatr Gerontol Int 24:619\u2013625","journal-title":"Geriatr Gerontol Int"},{"key":"1422_CR41","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2024.104959","volume":"162","author":"C-R Wu","year":"2025","unstructured":"Wu C-R, Chang K-M, Tranyor V, Chiu H-Y (2025) Global incidence and prevalence of delirium and its risk factors in medically hospitalized older patients: a systematic review and meta-analysis. Int J Nurs Stud 162:104959","journal-title":"Int J Nurs Stud"},{"key":"1422_CR42","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1016\/j.jamda.2008.09.006","volume":"10","author":"P Voyer","year":"2009","unstructured":"Voyer P, Richard S, Doucet L, Carmichael P-H (2009) Detecting delirium and subsyndromal delirium using different diagnostic criteria among demented long-term care residents. J Am Med Dir Assoc 10:181\u2013188","journal-title":"J Am Med Dir Assoc"},{"key":"1422_CR43","first-page":"904","volume":"99","author":"R Praditsuwan","year":"2016","unstructured":"Praditsuwan R, Srinonprasert V (2016) Unrecognized delirium is prevalent among older patients admitted to general medical wards and lead to higher mortality rate. J Med Assoc Thai 99:904\u2013912","journal-title":"J Med Assoc Thai"},{"key":"1422_CR44","doi-asserted-by":"publisher","first-page":"afab214","DOI":"10.1093\/ageing\/afab214","volume":"51","author":"JS Lee","year":"2022","unstructured":"Lee JS, Tong T, Chignell M, Tierney MC, Goldstein J, Eagles D et al (2022) Prevalence, management and outcomes of unrecognized delirium in a National Sample of 1,493 older emergency department patients: how many were sent home and what happened to them? Age Ageing 51:afab214","journal-title":"Age Ageing"},{"key":"1422_CR45","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1016\/j.jamda.2013.04.005","volume":"14","author":"D Tolson","year":"2013","unstructured":"Tolson D, Rolland Y, Katz PR, Woo J, Morley JE, Vellas B (2013) An international survey of nursing homes. J Am Med Dir Assoc 14:459\u2013462","journal-title":"J Am Med Dir Assoc"},{"key":"1422_CR46","unstructured":"American Psychiatric Association (APA) (1987) Diagnostic and statistical manual of mental disorders. 3th rev. edn. American Psychiatric Association, Washington"},{"key":"1422_CR47","unstructured":"American Psychiatric Association (APA) (1994) Diagnostic and statistical manual of mental disorders. 4th edn. American Psychiatric Association, Washington"},{"key":"1422_CR48","unstructured":"American Psychiatric Association (APA) (2000) Diagnostic and statistical manual of mental disorders. 4th text rev. edn. American Psychiatric Association, Washington"},{"key":"1422_CR49","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (APA) (2013) Diagnostic and statistical manual of mental disorders. 5th edn. American Psychiatric Association, Washington","DOI":"10.1176\/appi.books.9780890425596"},{"key":"1422_CR50","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1017\/S1041610214002853","volume":"27","author":"D Adamis","year":"2015","unstructured":"Adamis D, Rooney S, Meagher D, Mulligan O, McCarthy G (2015) A comparison of delirium diagnosis in elderly medical inpatients using the CAM, DRS-R98, DSM-IV and DSM-5 criteria. Int Psychogeriatr 27:883\u2013889","journal-title":"Int Psychogeriatr"},{"key":"1422_CR51","doi-asserted-by":"publisher","first-page":"941","DOI":"10.7326\/0003-4819-113-12-941","volume":"113","author":"SK Inouye","year":"1990","unstructured":"Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI (1990) Clarifying confusion: the confusion assessment method: a new method for detection of delirium. Ann Intern Med 113:941\u2013948","journal-title":"Ann Intern Med"},{"key":"1422_CR52","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1891\/rtnp.17.1.31.53169","volume":"17","author":"MJ Schuurmans","year":"2003","unstructured":"Schuurmans MJ, Shortridge-Baggett LM, Duursma SA (2003) The Delirium Observation Screening Scale: a screening instrument for delirium. Res Theory Nurs Pract 17:31","journal-title":"Res Theory Nurs Pract"},{"key":"1422_CR53","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1093\/ageing\/afu021","volume":"43","author":"G Bellelli","year":"2014","unstructured":"Bellelli G, Morandi A, Davis DH, Mazzola P, Turco R, Gentile S et al (2014) Validation of the 4AT, a new instrument for rapid delirium screening: a study in 234 hospitalised older people. Age Ageing 43:496\u2013502","journal-title":"Age Ageing"},{"key":"1422_CR54","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1111\/jgs.16879","volume":"69","author":"BK Helfand","year":"2021","unstructured":"Helfand BK, D\u2019Aquila ML, Tabloski P, Erickson K, Yue J, Fong TG et al (2021) Detecting delirium: a systematic review of identification instruments for non-ICU settings. J Am Geriatr Soc 69:547\u2013555","journal-title":"J Am Geriatr Soc"},{"key":"1422_CR55","doi-asserted-by":"publisher","DOI":"10.1007\/s41999-025-01250-8","author":"I Mansutti","year":"2025","unstructured":"Mansutti I, Muzzana C, Vater V, Dettwiler PU, Palese A, Ausserhofer D et al (2025) Delirium in nursing homes and long-term care facilities: findings of a scoping review of detection tools. Eur Geriatr Med. https:\/\/doi.org\/10.1007\/s41999-025-01250-8","journal-title":"Eur Geriatr Med"},{"key":"1422_CR56","doi-asserted-by":"publisher","first-page":"1217","DOI":"10.1002\/gps.5120","volume":"34","author":"JG Franco","year":"2019","unstructured":"Franco JG, Trzepacz PT, Gaviria AM, Sep\u00falveda E, Vi\u00f1uelas E, Palma J et al (2019) Distinguishing characteristics of delirium in a skilled nursing facility in Spain: influence of baseline cognitive status. Int J Geriatr Psychiatry 34:1217\u20131225","journal-title":"Int J Geriatr Psychiatry"},{"key":"1422_CR57","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1001\/archinte.1995.00430030095011","volume":"155","author":"P Pompei","year":"1995","unstructured":"Pompei P, Foreman M, Cassel CK, Alessi C, Cox D (1995) Detecting delirium among hospitalized older patients. Arch Intern Med 155:301\u2013307","journal-title":"Arch Intern Med"},{"key":"1422_CR58","doi-asserted-by":"publisher","first-page":"1112","DOI":"10.1002\/gps.753","volume":"17","author":"JV Laurila","year":"2002","unstructured":"Laurila JV, Pitkala K, Strandberg TE, Tilvis RS (2002) Confusion assessment method in the diagnostics of delirium among aged hospital patients: would it serve better in screening than as a diagnostic instrument? Int J Geriatr Psychiatry 17:1112\u20131119","journal-title":"Int J Geriatr Psychiatry"},{"key":"1422_CR59","doi-asserted-by":"publisher","first-page":"1322","DOI":"10.1002\/gps.4615","volume":"32","author":"J De","year":"2017","unstructured":"De J, Wand APF, Smerdely PI, Hunt GE (2017) Validating the 4A\u2019s test in screening for delirium in a culturally diverse geriatric inpatient population. Int J Geriatr Psychiatry 32:1322\u20131329","journal-title":"Int J Geriatr Psychiatry"},{"key":"1422_CR60","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1097\/MEJ.0b013e32833777ab","volume":"17","author":"I Schofield","year":"2010","unstructured":"Schofield I, Stott DJ, Tolson D, McFadyen A, Monaghan J, Nelson D (2010) Screening for cognitive impairment in older people attending accident and emergency using the 4-item abbreviated mental test. Eur J Emerg Med 17:340\u2013342","journal-title":"Eur J Emerg Med"},{"key":"1422_CR61","doi-asserted-by":"publisher","first-page":"305","DOI":"10.5498\/wjp.v5.i3.305","volume":"5","author":"J Meagher","year":"2015","unstructured":"Meagher J, Leonard M, Donoghue L, O\u2019Regan N, Timmons S, Exton C et al (2015) Months backward test: a review of its use in clinical studies. World J Psychiatr 5:305","journal-title":"World J Psychiatr"},{"key":"1422_CR62","doi-asserted-by":"publisher","first-page":"7515","DOI":"10.3390\/ijerph17207515","volume":"17","author":"E Jeong","year":"2020","unstructured":"Jeong E, Park J, Lee J (2020) Diagnostic test accuracy of the 4AT for delirium detection: a systematic review and meta-analysis. Int J Environ Res Public Health 17:7515","journal-title":"Int J Environ Res Public Health"},{"key":"1422_CR63","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1080\/13607860903421011","volume":"14","author":"D Adamis","year":"2010","unstructured":"Adamis D, Sharma N, Whelan PJ, Macdonald AJ (2010) Delirium scales: a review of current evidence. Aging Ment Health 14:543\u2013555","journal-title":"Aging Ment Health"},{"key":"1422_CR64","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1002\/gps.1449","volume":"21","author":"KB Bj\u00f6rkelund","year":"2006","unstructured":"Bj\u00f6rkelund KB, Larsson S, Gustafson L, Andersson E (2006) The organic brain syndrome (OBS) scale: a systematic review. Int J Geriatr Psychiatry 21:210\u2013222","journal-title":"Int J Geriatr Psychiatry"},{"key":"1422_CR65","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1093\/oso\/9780192632753.003.0002","volume-title":"Delirium in old age","author":"B Robertsson","year":"2002","unstructured":"Robertsson B (2002) The instrumentation of delirium. In: Lindesay J, Rockwood K, Macdonald A (eds) Delirium in old age. Oxford Academic, New York, NY, pp 9\u201325"},{"key":"1422_CR66","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1080\/14017430260180436","volume":"36","author":"M Eriksson","year":"2002","unstructured":"Eriksson M, Samuelsson E, Gustafson Y, \u00c5berg T, Engstr\u00f6m KG (2002) Delirium after coronary bypass surgery evaluated by the organic brain syndrome protocol. Scand Cardiovasc J 36:250\u2013255","journal-title":"Scand Cardiovasc J"},{"key":"1422_CR67","doi-asserted-by":"publisher","first-page":"22","DOI":"10.3390\/geriatrics8010022","volume":"8","author":"P Shrestha","year":"2023","unstructured":"Shrestha P, Fick DM (2023) Recognition of delirium superimposed on dementia: is there an ideal tool? Geriatrics 8:22","journal-title":"Geriatrics"},{"key":"1422_CR68","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1111\/j.1532-5415.2008.01674.x","volume":"56","author":"LA Wei","year":"2008","unstructured":"Wei LA, Fearing MA, Sternberg EJ, Inouye SK (2008) The confusion assessment method: a systematic review of current usage. J Am Geriatr Soc 56:823\u2013830","journal-title":"J Am Geriatr Soc"},{"key":"1422_CR69","doi-asserted-by":"publisher","first-page":"2008","DOI":"10.1111\/jocn.15487","volume":"31","author":"L Pu","year":"2022","unstructured":"Pu L, Moyle W (2022) Restraint use in residents with dementia living in residential aged care facilities: a scoping review. J Clin Nurs 31:2008\u20132023","journal-title":"J Clin Nurs"},{"key":"1422_CR70","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1093\/ageing\/afr032","volume":"40","author":"A Larrayadieu","year":"2011","unstructured":"Larrayadieu A, Abellan van Kan G, Piau A, Soto Martin M, Nourhashemi F, Rolland Y et al (2011) Associated factors with antipsychotic use in assisted living facilities: a cross-sectional study of 4367 residents. Age Ageing 40:368\u2013375","journal-title":"Age Ageing"},{"key":"1422_CR71","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1016\/j.jamda.2013.02.022","volume":"14","author":"BK Tamura","year":"2013","unstructured":"Tamura BK, Bell CL, Masaki KH, Amella EJ (2013) Factors associated with weight loss, low BMI, and malnutrition among nursing home patients: a systematic review of the literature. J Am Med Dir Assoc 14:649\u2013655","journal-title":"J Am Med Dir Assoc"},{"key":"1422_CR72","doi-asserted-by":"publisher","first-page":"1164","DOI":"10.1097\/MLR.0b013e3181b58a69","volume":"47","author":"NG Castle","year":"2009","unstructured":"Castle NG, Engberg J (2009) The health consequences of using physical restraints in nursing homes. Med Care 47:1164\u20131173","journal-title":"Med Care"},{"key":"1422_CR73","doi-asserted-by":"crossref","unstructured":"Foebel AD, Onder G, Finne-Soveri H, Lukas A, Denkinger MD, Carfi A et al (2016) Physical restraint and antipsychotic medication use among nursing home residents with dementia. J Am Med Dir Assoc 17:184.e9\u2013184.e14","DOI":"10.1016\/j.jamda.2015.11.014"},{"key":"1422_CR74","volume-title":"Cochrane handbook for systematic reviews of interventions version 65","author":"JJ Deeks","year":"2024","unstructured":"Deeks JJ, Higgins JPT, Altman DG, McKenzie JE, Veroniki AA (2024) Chapter 10: analysing data and undertaking meta-analyses. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ et al (eds) Cochrane handbook for systematic reviews of interventions version 65. Cochrane"},{"key":"1422_CR75","doi-asserted-by":"publisher","first-page":"437","DOI":"10.2147\/NDT.S97228","volume":"12","author":"S Kuladee","year":"2016","unstructured":"Kuladee S, Prachason T (2016) Development and validation of the Thai version of the 4 \u2018A\u2019s Test for delirium screening in hospitalized elderly patients with acute medical illnesses. Neuropsychiatr Dis Treat 12:437\u2013443","journal-title":"Neuropsychiatr Dis Treat"},{"key":"1422_CR76","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1093\/geront\/10.1_Part_1.20","volume":"10","author":"S Katz","year":"1970","unstructured":"Katz S, Downs TD, Cash HR, Grotz RC (1970) Progress in development of the index of ADL. Gerontologist 10:20\u201330","journal-title":"Gerontologist"},{"key":"1422_CR77","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1111\/j.1532-5415.2005.53221.x","volume":"53","author":"ZS Nasreddine","year":"2005","unstructured":"Nasreddine ZS, Phillips NA, B\u00e9dirian V, Charbonneau S, Whitehead V, Collin I et al (2005) The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 53:695\u2013699","journal-title":"J Am Geriatr Soc"},{"key":"1422_CR78","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1016\/0895-4356(89)90065-6","volume":"42","author":"S Shah","year":"1989","unstructured":"Shah S, Vanclay F, Cooper B (1989) Improving the sensitivity of the Barthel Index for stroke rehabilitation. J Clin Epidemiol 42:703\u2013709","journal-title":"J Clin Epidemiol"},{"key":"1422_CR79","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1017\/S1041610294001651","volume":"6","author":"L R\u00f6nnberg","year":"1994","unstructured":"R\u00f6nnberg L, Ericsson K (1994) Reliability and validity of the Hierarchic Dementia Scale. Int Psychogeriatr 6:87\u201394","journal-title":"Int Psychogeriatr"},{"key":"1422_CR80","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/0006-3223(88)90038-8","volume":"23","author":"GS Alexopoulos","year":"1988","unstructured":"Alexopoulos GS, Abrams RC, Young RC, Shamoian CA (1988) Cornell scale for depression in dementia. Biol Psychiatry 23:271\u2013284","journal-title":"Biol Psychiatry"},{"key":"1422_CR81","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1080\/08039480600937066","volume":"60","author":"A K\u00f8rner","year":"2006","unstructured":"K\u00f8rner A, Lauritzen L, Abelskov K, Gulmann N, Marie Brodersen A, Wedervang-Jensen T et al (2006) The geriatric depression scale and the cornell scale for depression in dementia. A validity study. Nord J Psychiatry 60:360\u2013364","journal-title":"Nord J Psychiatry"}],"container-title":["European Geriatric Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s41999-026-01422-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s41999-026-01422-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s41999-026-01422-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T10:03:34Z","timestamp":1782468214000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s41999-026-01422-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,19]]},"references-count":81,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["1422"],"URL":"https:\/\/doi.org\/10.1007\/s41999-026-01422-0","relation":{},"ISSN":["1878-7657"],"issn-type":[{"value":"1878-7657","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,19]]},"assertion":[{"value":"24 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 January 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 January 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no competing interests to declare that are relevant to the content of this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethical approval and written consent were not required.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"For this type of study, no informed consent is required.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}