{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T03:23:45Z","timestamp":1778729025554,"version":"3.51.4"},"reference-count":35,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nursing Reports"],"abstract":"<jats:p>Background\/Objectives: Older adults with cancer are at high risk of developing delirium. Comprehensive geriatric assessment (CGA) is a fundamental tool for prioritizing problems and establishing appropriate interventions in older patients. This study aimed to identify risk factors for delirium through a CGA in older adults receiving palliative cancer care in hospital. Methods: This longitudinal observational study included people aged 65 years or over who were hospitalized in medical wards with an advanced stage of cancer. Clinicians performed a CGA and screened for delirium using the Confusion Assessment Method (CAM). Diagnosis of delirium was based on criteria set out in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). We calculated odds ratios (ORs) with 95% confidence intervals (CIs) to compare different variables in people with versus without delirium. Results: The study included 105 participants, of whom 67 (63.81%) developed delirium during follow-up. The mean age was 71.33 years in the delirium group and 72.24 years in the non-delirium group. Risk factors for delirium were dysphagia (OR 2.45, 95% CI 1.01\u20135.99; p = 0.045), urinary catheterization (OR 2.97, 95% CI 1.09\u20138.13; p = 0.029), and having at least one delirium episode in the last year (OR 5.68, 95% CI 1.97\u201316.34; p = 0.001). The predictive model showed that older male cancer patients with a urinary catheter and dysphagia are most likely to develop delirium in hospital (area under the curve [AUC] = 0.679, 95% CI 0.577\u20130.780; p = 0.002). Conclusions: The prevention and effective management of delirium require a person-centered, interdisciplinary approach that considers both clinical and psychosocial aspects. Including variables such as male sex, dysphagia, and urinary catheterization in delirium risk assessment enables more comprehensive and personalized management.<\/jats:p>","DOI":"10.3390\/nursrep15090328","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T12:15:17Z","timestamp":1757420117000},"page":"328","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Identifying Risk Factors for Delirium Through Comprehensive Geriatric Assessment in Older Adults Receiving Palliative Cancer Care"],"prefix":"10.3390","volume":"15","author":[{"given":"Paula","family":"Llisterri-S\u00e1nchez","sequence":"first","affiliation":[{"name":"Doctoral School, Catholic University of Valencia San Vicente M\u00e1rtir, 46001 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1949-3290","authenticated-orcid":false,"given":"Francisco Miguel","family":"Mart\u00ednez-Arnau","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, University of Valencia, Gasc\u00f3 Oliag 5, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2118-9792","authenticated-orcid":false,"given":"Pilar","family":"P\u00e9rez-Ros","sequence":"additional","affiliation":[{"name":"Department of Nursing, University of Valencia, Menendez Pelayo s\/n, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1002\/agm2.12347","article-title":"The Increasing Prevalence of Cancer in the Elderly: An Investigation of Epidemiological Trends","volume":"7","author":"Prathap","year":"2024","journal-title":"Aging Med."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Deodhar, J.K., Sonkusare, L.N., and Goswami, S.S. (2024). Psychiatric Disorders in Older Adults with Cancer Referred to Psycho-Oncology Service in a Tertiary Care Cancer Centre: A 7-Year Real World Experience from India. BMC Psychiatry, 24.","DOI":"10.1186\/s12888-024-05492-x"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1001\/jama.2017.12067","article-title":"Delirium in Older Persons: Advances in Diagnosis and Treatment","volume":"318","author":"Oh","year":"2017","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"102457","DOI":"10.1016\/j.ejon.2023.102457","article-title":"Incidence of Delirium in Older People with Cancer: Systematic Review and Meta-Analysis","volume":"67","author":"Buigues","year":"2023","journal-title":"Eur. J. Oncol. Nurs."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1093\/ageing\/afz171","article-title":"Delirium at the End of Life","volume":"49","author":"Agar","year":"2020","journal-title":"Age Ageing"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1177\/02692163211065278","article-title":"Risk Factors for Delirium in Adult Patients Receiving Specialist Palliative Care: A Systematic Review and Meta-Analysis","volume":"36","author":"Featherstone","year":"2022","journal-title":"Palliat. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1017\/S1478951519000919","article-title":"Predisposing and Precipitating Risk Factors for Delirium in Palliative Care Patients","volume":"18","author":"Seiler","year":"2020","journal-title":"Palliat. Support. Care"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/j.jgo.2020.08.011","article-title":"Delirium Incidence, Risk Factors, and Treatments in Older Adults Receiving Chemotherapy: A Systematic Review and Meta-Analysis","volume":"12","author":"Jung","year":"2021","journal-title":"J. Geriatr. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1089\/jpm.2015.0416","article-title":"Predictors of Mortality for Delirium in Palliative Care","volume":"19","author":"Agar","year":"2016","journal-title":"J. Palliat. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1964","DOI":"10.1111\/jgs.18766","article-title":"Drugs, Delirium, and Ethics at the End of Life","volume":"72","author":"Thomas","year":"2024","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"102197","DOI":"10.1016\/j.jgo.2025.102197","article-title":"The Effect of Comprehensive Geriatric Assessment on Treatment Decisions, Supportive Care Received, and Postoperative Outcomes in Older Adults with Cancer Undergoing Surgery: A Systematic Review","volume":"16","author":"Disalvo","year":"2025","journal-title":"J. Geriatr. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1097\/SPC.0000000000000541","article-title":"Palliative and End-of-Life Care for the Older Adult with Cancer","volume":"15","author":"Huynh","year":"2021","journal-title":"Curr. Opin. Support Palliat. Care"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e13347","DOI":"10.1111\/eci.13347","article-title":"Comprehensive Geriatric Assessment in Older Adults with Cancer: Recommendations by the Italian Society of Geriatrics and Gerontology (SIGG)","volume":"51","author":"Fusco","year":"2021","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_14","first-page":"1","article-title":"Urinary Tract Infections in the Elderly: A Review of Disease Characteristics and Current Treatment Options","volume":"9","year":"2020","journal-title":"Drugs Context"},{"key":"ref_15","first-page":"61","article-title":"Functional Evaluation: The Barthel Index","volume":"14","author":"Mahoney","year":"1965","journal-title":"Md. State Med. J."},{"key":"ref_16","first-page":"456","article-title":"Overview of the MNA\u2014Its History and Challenges","volume":"10","author":"Vellas","year":"2006","journal-title":"J. Nutr. Health Aging"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"\u201cMini-Mental State\u201d. A Practical Method for Grading the Cognitive State of Patients for the Clinician","volume":"12","author":"Folstein","year":"1975","journal-title":"J. Psychiatr. Res."},{"key":"ref_18","first-page":"179","article-title":"La Escala Socio-Familiar de Gij\u00f3n: Instrumento \u00fatil en el hospital general","volume":"33","year":"1998","journal-title":"Rev. Esp. Geriatr. Gerontol. \u00d3rgano Of. Soc. Esp. Geriatr. Gerontol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"941","DOI":"10.7326\/0003-4819-113-12-941","article-title":"Clarifying Confusion: The Confusion Assessment Method. A New Method for Detection of Delirium","volume":"113","author":"Inouye","year":"1990","journal-title":"Ann. Intern. Med."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"European Delirium Association and American Delirium Society (2014). The DSM-5 Criteria, Level of Arousal and Delirium Diagnosis: Inclusiveness Is Safer. BMC Med., 12.","DOI":"10.1186\/s12916-014-0141-2"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s41999-021-00586-1","article-title":"The Detection of Delirium in Admitted Oncology Patients: A Scoping Review","volume":"13","author":"Sands","year":"2022","journal-title":"Eur. Geriatr. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.1177\/02692163211040186","article-title":"Outcomes and Measures of Delirium Interventional Studies in Palliative Care to Inform a Core Outcome Set: A Systematic Review","volume":"35","author":"Agar","year":"2021","journal-title":"Palliat. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1038\/s41430-020-0629-0","article-title":"Relationship between Markers of Malnutrition and Clinical Outcomes in Older Adults with Cancer: Systematic Review, Narrative Synthesis and Meta-Analysis","volume":"74","author":"Bullock","year":"2020","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1111\/scs.13015","article-title":"Interventions to Optimise Nutrition in Older People in Hospitals and Long-Term Care: Umbrella Review","volume":"36","author":"Brunner","year":"2022","journal-title":"Scand. J. Caring Sci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1097\/SPC.0000000000000254","article-title":"Cancer-Related Cognitive Impairment in Older Adults","volume":"11","author":"Edelstein","year":"2017","journal-title":"Curr. Opin. Support. Palliat. Care"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/bs.acr.2022.04.001","article-title":"Chemobrain: A Review on Mechanistic Insight, Targets and Treatments","volume":"155","author":"Rao","year":"2022","journal-title":"Adv. Cancer Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.jgo.2019.09.005","article-title":"Social Support for Older Adults with Cancer: Young International Society of Geriatric Oncology Review Paper","volume":"11","author":"Kadambi","year":"2020","journal-title":"J. Geriatr. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1016\/j.jgo.2022.04.008","article-title":"Geriatric Assessment in the Management of Older Patients with Cancer\u2014A Systematic Review (Update)","volume":"13","author":"Hamaker","year":"2022","journal-title":"J. Geriatr. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"101585","DOI":"10.1016\/j.jgo.2023.101585","article-title":"The Effect of Comprehensive Geriatric Assessment on Care Received, Treatment Completion, Toxicity, Cancer-Related and Geriatric Assessment Outcomes, and Quality of Life for Older Adults Receiving Systemic Anti-Cancer Treatment: A Systematic Review","volume":"14","author":"Disalvo","year":"2023","journal-title":"J. Geriatr. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Guo, D., Lin, T., Deng, C., Zheng, Y., Gao, L., and Yue, J. (2021). Risk Factors for Delirium in the Palliative Care Population: A Systematic Review and Meta-Analysis. Front. Psychiatry, 12.","DOI":"10.3389\/fpsyt.2021.772387"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1007\/s40520-018-0974-1","article-title":"The Association of Indwelling Urinary Catheter with Delirium in Hospitalized Patients and Nursing Home Residents: An Explorative Analysis from the \u201cDelirium Day 2015\u201d","volume":"31","author":"Bo","year":"2019","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/j.annemergmed.2021.03.005","article-title":"Risk Factors for Delirium in Older Adults in the Emergency Department: A Systematic Review and Meta-Analysis","volume":"78","author":"Berning","year":"2021","journal-title":"Ann. Emerg. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.jpainsymman.2021.09.001","article-title":"The Impact of Aging on Symptom Prevalence and Management in Terminally Ill Patients with Cancer","volume":"63","author":"Tatokoro","year":"2022","journal-title":"J. Pain Symptom Manag."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"E5","DOI":"10.3171\/2014.9.FOCUS14493","article-title":"Home Palliative Care and End of Life Issues in Glioblastoma Multiforme: Results and Comments from a Homogeneous Cohort of Patients","volume":"37","author":"Pompili","year":"2014","journal-title":"Neurosurg. Focus"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Arnold, E., Lugton, J., Spiller, J., and Finucane, A. (2025). What Are the Experiences and Support Needs of District Nurses Caring for Terminally Ill People with Delirium at Home? A Qualitative Study. BMC Palliat. Care, 24.","DOI":"10.1186\/s12904-024-01627-9"}],"container-title":["Nursing Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-4403\/15\/9\/328\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:42:18Z","timestamp":1760035338000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-4403\/15\/9\/328"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,8]]},"references-count":35,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["nursrep15090328"],"URL":"https:\/\/doi.org\/10.3390\/nursrep15090328","relation":{},"ISSN":["2039-4403"],"issn-type":[{"value":"2039-4403","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,8]]}}}