{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T23:31:54Z","timestamp":1783467114492,"version":"3.55.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2019,3,30]],"date-time":"2019-03-30T00:00:00Z","timestamp":1553904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Wellcome Intermediate Clinical Fellowship","award":["WT107467"],"award-info":[{"award-number":["WT107467"]}]},{"DOI":"10.13039\/100007670","name":"Dalhousie Medical Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007670","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008252","name":"Health Sciences Centre Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008252","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000143","name":"Alzheimer\u2019s Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000143","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Clinical Research Training Fellowship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Clinical and research interest in delirium has been rising over the last 15 years. The Scottish Intercollegiate Guidelines Network (SIGN) publication on delirium is a state-of-the-art synthesis of the field, and the first UK guideline since 2010.<\/jats:p><jats:p>There is new guidance around delirium detection, particularly in recommending the 4 \u2018A\u2019s Test (4AT). The 4AT has the advantage of being brief, embeds and operationalises cognitive testing, and is scalable with little training. The guidelines highlight the importance of non-pharmacological management for all hospital presentations involving the spectrum of cognitive disorders (delirium, dementia but at risk of delirium, delirium superimposed on dementia). Pharmacotherapy has a minimal role, but specific indications (e.g. intractable distress) are discussed.<\/jats:p><jats:p>Advances in delirium research, education and policy, have come together with steady changes in the sociocultural context in which healthcare systems look after older people with cognitive impairment. However, there remains a gap between desired and actual clinical practice, one which might be bridged by re-engaging with compassionate, patient-centred care. In this respect, these SIGN guidelines offer a key resource.<\/jats:p>","DOI":"10.1093\/ageing\/afz036","type":"journal-article","created":{"date-parts":[[2019,3,18]],"date-time":"2019-03-18T12:39:51Z","timestamp":1552912791000},"page":"485-488","source":"Crossref","is-referenced-by-count":58,"title":["The Scottish Intercollegiate Guidelines Network: risk reduction and management of delirium"],"prefix":"10.1093","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1560-1955","authenticated-orcid":false,"given":"Daniel","family":"Davis","sequence":"first","affiliation":[{"name":"MRC Unit for Lifelong Health and Ageing at UCL, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel D","family":"Searle","sequence":"additional","affiliation":[{"name":"MRC Unit for Lifelong Health and Ageing at UCL, London, UK"},{"name":"Division of Geriatric Medicine, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Tsui","sequence":"additional","affiliation":[{"name":"MRC Unit for Lifelong Health and Ageing at UCL, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,3,30]]},"reference":[{"key":"2023022012280228200_","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1093\/ageing\/aft148","article-title":"New horizons in the pathogenesis, assessment and management of delirium","volume":"42","author":"Maclullich","year":"2013","journal-title":"Age Ageing"},{"key":"2023022012280228200_","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1177\/0957154X07076467","article-title":"A brief review of the history of delirium as a mental disorder","volume":"18","author":"Adamis","year":"2007","journal-title":"Hist Psychiatry"},{"key":"2023022012280228200_","doi-asserted-by":"crossref","first-page":"375","DOI":"10.7326\/0003-4819-158-5-201303051-00003","article-title":"In-facility delirium prevention programs as a patient safety strategy: a systematic review","volume":"158","author":"Reston","year":"2013","journal-title":"Ann Intern Med"},{"key":"2023022012280228200_","author":"Scottish Intercollegiate Guidelines Network","year":"2019"},{"key":"2023022012280228200_","volume-title":"Delirium: diagnosis, prevention, and management of delirium","author":"National Institute for Health and Clinical Excellence","year":"2010"},{"key":"2023022012280228200_","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1093\/ageing\/afq157","article-title":"Under-reporting of delirium in the NHS","volume":"40","author":"Clegg","year":"2011","journal-title":"Age Ageing"},{"key":"2023022012280228200_","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1093\/ageing\/afp201","article-title":"Detection of delirium in the acute hospital","volume":"39","author":"Collins","year":"2010","journal-title":"Age Ageing"},{"key":"2023022012280228200_","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1093\/ageing\/afu021","article-title":"Validation of the 4AT, a new instrument for rapid delirium screening: a study in 234 hospitalised older people","volume":"43","author":"Bellelli","year":"2014","journal-title":"Age Ageing"},{"key":"2023022012280228200_","doi-asserted-by":"crossref","first-page":"554","DOI":"10.7326\/M14-0865","article-title":"3D-CAM: derivation and validation of a 3-minute diagnostic interview for CAM-defined delirium: a cross-sectional diagnostic test study","volume":"161","author":"Marcantonio","year":"2014","journal-title":"Ann Intern Med"},{"key":"2023022012280228200_","doi-asserted-by":"crossref","first-page":"941","DOI":"10.7326\/0003-4819-113-12-941","article-title":"Clarifying confusion: the confusion assessment method. 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