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Purpose <p>Neurocognitive disorders (NCDs), including delirium, cognitive impairment, or dementia, are prevalent in older patients with physical trauma in acute care settings. Identifying NCDs in these patients can enhance care decisions to improve outcomes. This study aimed to identify the diagnostic accuracy of screening tools for NCDs in older patients with trauma in acute care settings.</p> Methods <p>Electronic databases (MEDLINE, Embase, CINAHL, PsycInfo, Cochrane Library) were searched from inception to 01 March 2024. Inclusion criteria were: older adults (≥ 60&#xa0;years); admitted to acute care setting following physical trauma; diagnostic accuracy study of a screening tool for (1) delirium and/or (2) cognitive impairment or dementia against a reference standard of a clinical diagnosis (standard diagnostic criteria or validated tool). Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A narrative synthesis was conducted. Methodological heterogeneity between the studies precluded meta-analysis.</p> Results <p>Five studies examining five different screening tools for delirium in older adults, all with hip fracture, were included. Studies reported wide variance in sensitivity (76.9–91.8) and specificity (54.5–99). Prevalence of detected delirium varied widely across studies (6.7–31.5%). All studies had a high or unclear risk of bias in at least one domain. No studies were found to examine the diagnostic accuracy of screening tools for cognitive impairment in older patients with trauma.</p> Conclusion <p>This systematic review highlights the dearth of studies validating screening tools for NCDs in older patients following trauma in acute care settings.</p> PROSPERO Registration number <p>CRD42024518730.</p>

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Diagnostic test accuracy of screening tools for the detection of neurocognitive disorders in older adults post-trauma in acute care settings: a systematic review

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月18日

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  • Niamh A. Merriman,
  • Mary E. Walsh,
  • Helena Ferris,
  • Eithne Sexton,
  • Niamh O’Regan,
  • Rose S. Penfold,
  • Marie Carrigan,
  • Tara Coughlan,
  • Lorna Gurren,
  • Jodie Adams,
  • Chris Reidy,
  • Arveen Jeyaseelan,
  • Patrick Doyle,
  • Mubashra Ashraf,
  • Tomás Ó Flatharta,
  • Siofra Hearne,
  • Jane Gaffey,
  • Louise Brent,
  • Pamela Hickey,
  • Catherine Blake

摘要

Purpose

Neurocognitive disorders (NCDs), including delirium, cognitive impairment, or dementia, are prevalent in older patients with physical trauma in acute care settings. Identifying NCDs in these patients can enhance care decisions to improve outcomes. This study aimed to identify the diagnostic accuracy of screening tools for NCDs in older patients with trauma in acute care settings.

Methods

Electronic databases (MEDLINE, Embase, CINAHL, PsycInfo, Cochrane Library) were searched from inception to 01 March 2024. Inclusion criteria were: older adults (≥ 60 years); admitted to acute care setting following physical trauma; diagnostic accuracy study of a screening tool for (1) delirium and/or (2) cognitive impairment or dementia against a reference standard of a clinical diagnosis (standard diagnostic criteria or validated tool). Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A narrative synthesis was conducted. Methodological heterogeneity between the studies precluded meta-analysis.

Results

Five studies examining five different screening tools for delirium in older adults, all with hip fracture, were included. Studies reported wide variance in sensitivity (76.9–91.8) and specificity (54.5–99). Prevalence of detected delirium varied widely across studies (6.7–31.5%). All studies had a high or unclear risk of bias in at least one domain. No studies were found to examine the diagnostic accuracy of screening tools for cognitive impairment in older patients with trauma.

Conclusion

This systematic review highlights the dearth of studies validating screening tools for NCDs in older patients following trauma in acute care settings.

PROSPERO Registration number

CRD42024518730.