{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T09:07:14Z","timestamp":1789549634245,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP19k11320"],"award-info":[{"award-number":["JP19k11320"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP23k10399"],"award-info":[{"award-number":["JP23k10399"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psychogeriatrics"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postoperative delirium (POD) is a common complication in older adults after hip fracture surgery. Although cognitive impairment is a key risk factor, accurately assessing baseline cognition in acute settings remains challenging. Informant\u2010based tools may better reflect premorbid cognitive status; however, their utility in hip fracture populations is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective analysis used data from a prospective cohort of patients aged \u2265\u200980\u2009years who underwent hip fracture surgery at two acute hospitals in Japan. Pre\u2010fracture cognitive status was assessed using the Dementia Assessment Sheet for Community\u2010based Integrated Care System (DASC\u201021), primarily based on reports from informants. For selected patients without available informants and with Mini\u2010Mental State Examination (MMSE) scores \u2265\u200921, structured patient interviews and clinical observations were used. The DASC\u201021 categories were classified as normal cognition, mild impairment and moderate\u2010to\u2010severe impairment. Cognitive function at admission was evaluated using the MMSE. POD was assessed using the Confusion Assessment Method within the first three postoperative days. Multivariable logistic regression analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 368 patients, 137 (37.2%) developed POD. POD incidence increased with worsening pre\u2010fracture cognitive impairment (5.6%, 44.3% and 48.7% for normal, mild and moderate\u2010to\u2010severe impairment, respectively;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Each 1\u2010point increase in the MMSE score was associated with lower odds of POD (OR 0.91, 95% CI 0.88\u20130.94). Compared with normal cognition, the adjusted ORs for POD were 14.11 (95% CI 5.08\u201339.24) for mild impairment and 15.39 (95% CI 5.56\u201342.61) for moderate\u2010to\u2010severe impairment. Discrimination was similar between MMSE and DASC\u201021 (area under the receiver operating characteristic curve 0.75 vs. 0.74).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pre\u2010fracture cognitive impairment, including DASC\u201021\u2010defined mild impairment, was associated with POD. The DASC\u201021 categories showed comparable discriminative performance to the MMSE and may help estimate baseline cognitive vulnerability in acute clinical settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/psyg.70195","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T07:43:28Z","timestamp":1784879008000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pre\u2010Fracture Cognitive Assessment Using the\n                    <scp>DASC<\/scp>\n                    \u201021 and Postoperative Delirium Risk"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2973-2064","authenticated-orcid":false,"given":"Tomoko","family":"Kamimura","sequence":"first","affiliation":[{"name":"Department of Health Sciences Shinshu University School of Medicine  Matsumoto Nagano Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Tamaki","sequence":"additional","affiliation":[{"name":"Kamiiida\u2010Daiichi General Hospital  Nagoya Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuya","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Aizawa Hospital  Matsumoto Nagano Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4061-2646","authenticated-orcid":false,"given":"Keita","family":"Tomii","sequence":"additional","affiliation":[{"name":"Aizawa Hospital  Matsumoto Nagano Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-023-06907-3"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-019-05172-7"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOSGlobal\u2010D\u201020\u201000221"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2022.960364"},{"key":"e_1_2_9_6_1","first-page":"470","article-title":"Delirium on Presentation With a Hip Fracture Is Associated With Adverse Outcomes: A Multicentre Observational Study of 18,040 Patients Using National Clinical Registry Data","volume":"107","author":"Penfold R. S.","year":"2025","journal-title":"Bone & Joint Journal"},{"key":"e_1_2_9_7_1","first-page":"829","article-title":"Health Economic Implications of Perioperative Delirium in Older Patients After Surgery for a Fragility Hip Fracture","volume":"97","author":"Zywiel M. G.","year":"2015","journal-title":"Journal of Bone and Joint Surgery. American Volume"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.13838"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijotn.2018.11.001"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-022-06640-3"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.4655"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.5408"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.49950"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1226473"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17207467"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0139879"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.12806"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11845-019-02011-w"},{"key":"e_1_2_9_19_1","first-page":"1675","article-title":"Factors Associated With Delirium and Cognitive Decline Following Hip Fracture Surgery","volume":"102","author":"Uzoigwe C. E.","year":"2020","journal-title":"Bone & Joint Journal"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2017.10.010"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2022.959510"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.12727"},{"key":"e_1_2_9_23_1","unstructured":"S.Awata \u201cThe Dementia Assessment Sheet for Community\u2010Based Integrated Care System (DASC\u201021) \u201daccessed April 7 2026 https:\/\/dasc.jp\/wp\u2010content\/uploads\/2018\/05\/Dementia\u2010Assessment\u2010Sheet\u2010for\u2010the\u2010Community\u2010based\u2010Integrated\u2010Care\u2010System_21itemsDASC\u201021\u2010Manual.pdf."},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2024.01.030"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.JGP.0000192478.82189.a8"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(89)90065-6"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.12968\/ijtr.2011.18.8.422"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"}],"container-title":["Psychogeriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/psyg.70195","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/psyg.70195","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/psyg.70195","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T08:33:48Z","timestamp":1789547628000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/psyg.70195"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,24]]},"references-count":27,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/psyg.70195"],"URL":"https:\/\/doi.org\/10.1111\/psyg.70195","archive":["Portico"],"relation":{},"ISSN":["1346-3500","1479-8301"],"issn-type":[{"value":"1346-3500","type":"print"},{"value":"1479-8301","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,24]]},"assertion":[{"value":"2026-04-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70195"}}