Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun;16(3):861-869.
doi: 10.1007/s41999-025-01191-2. Epub 2025 Apr 20.

Development of a checklist for systematic screening of precipitating factors in older patients admitted to hospital with delirium

Carmelo Lafuente-Lafuente  1   2 , Evany Heinichen Candia  3 , Eric Pautas  4 , Yonathan Freund  5 , Bruno Oquendo  6 , Joël Belmin  6   7 ; Improving Management of Delirium in Older Patients (IMDO) Investigators
Collaborators, Affiliations

Development of a checklist for systematic screening of precipitating factors in older patients admitted to hospital with delirium

Carmelo Lafuente-Lafuente et al. Eur Geriatr Med. 2025 Jun.

Abstract

Objectives: Causes of delirium are often multiple in older people and a significant number of them are missed at the initial assessment. We wanted to develop a checklist to help clinicians to systematically screen for the most frequent and important causes of delirium in this population.

Methods: Three investigators, based on previous studies, drafted three possible checklist base models, comprising 18-29 items. A panel of 12 experts voted to choose one of the models, and then followed a modified Delphi consensus method to review each item and further develop the checklist. The consensus checklist was then tested in a small group of patients. The target population was older patients with delirium arriving to the emergency department or to a medical hospital ward.

Results: The longest of the three drafts was unanimously chosen by the panel. After three rounds, a consensus was reached and a final checklist agreed. It is composed by 27 items organized in five groups of causes: infections, hydro-electrolytic disturbances, drugs, acute neurological conditions, and other acute diseases. A pilot study conducted by 15 physicians in 21 consecutive patients showed that the checklist was easy to complete, quick (mean 4 min) and most clinicians, though it helped them through the initial diagnostic work.

Conclusions: We have developed and pilot tested a checklist for screening for acute precipitants of delirium in older patients, aimed to facilitate early recognition and treatment of the multiple causes that often coexists in this population.

Keywords: Checklist; Clinical diagnosis; Delirium; Etiology; Older people; Precipitating factors.

PubMed Disclaimer

Conflict of interest statement

Declarations. Conflict of interest: Dr Lafuente-Lafuente received honoraria for lectures from Boheringer, support for attending meetings from Pfizer. Pr Belmin received honoraria for lectures and participation on advisory boards from Pfizer, Boehringer Ingelheim, Novartis and Janssen. Dr Evany Candia, Dr Oquendo, Pr Freund, Pr Pautas have no relevant financial or non-financial interests to disclose. Ethical statement: The pilot study was approved by the corresponding regional ethics committee (Comité de Protection de Personnes d’Île-de-France II, study number 21.00279.000003 RIPH3 HPS). Informed consent: Informed consent was obtained from all participants included.

Figures

Fig. 1
Fig. 1
Methods followed to develop the checklist
See this image and copyright information in PMC

Similar articles

  • Global Delphi consensus on treatment goals for generalized pustular psoriasis.
    Barker JN, Casanova E, Choon SE, Foley P, Fujita H, Gonzalez C, Gooderham M, Marrakchi S, Puig L, Romiti R, Thaçi D, Zheng M, Strober B; Partnering for Innovation and Excellence in Rare Skin Diseases (PIONEERS®) Working Group and the DELPHI Panel. Barker JN, et al. Br J Dermatol. 2025 Mar 18;192(4):706-716. doi: 10.1093/bjd/ljae491. Br J Dermatol. 2025. PMID: 39844356
  • Surveillance for Violent Deaths - National Violent Death Reporting System, 50 States, the District of Columbia, and Puerto Rico, 2022.
    Forsberg K, Sheats KJ, Blair JM, Nguyen BL, Amoakohene E, Betz CJ, Lyons BH. Forsberg K, et al. MMWR Surveill Summ. 2025 Jun 12;74(5):1-42. doi: 10.15585/mmwr.ss7405a1. MMWR Surveill Summ. 2025. PMID: 40493548 Free PMC article.
  • CONSORT 2025 statement: updated guideline for reporting randomized trials.
    Hopewell S, Chan AW, Collins GS, Hróbjartsson A, Moher D, Schulz KF, Tunn R, Aggarwal R, Berkwits M, Berlin JA, Bhandari N, Butcher NJ, Campbell MK, Chidebe RCW, Elbourne D, Farmer A, Fergusson DA, Golub RM, Goodman SN, Hoffmann TC, Ioannidis JPA, Kahan BC, Knowles RL, Lamb SE, Lewis S, Loder E, Offringa M, Ravaud P, Richards DP, Rockhold FW, Schriger DL, Siegfried NL, Staniszewska S, Taylor RS, Thabane L, Torgerson D, Vohra S, White IR, Boutron I. Hopewell S, et al. Nat Med. 2025 Jun;31(6):1776-1783. doi: 10.1038/s41591-025-03635-5. Epub 2025 Apr 15. Nat Med. 2025. PMID: 40229553 Review.
  • Use of β-adrenoreceptor drugs and Parkinson's disease incidence in women from the French E3N cohort study.
    Nguyen TTH, Fournier A, Courtois É, Artaud F, Tubert-Bitter P, Severi G, Lee PC, Roze E, Ahmed I, Thiébaut AC, Elbaz A. Nguyen TTH, et al. J Parkinsons Dis. 2025 Jun;15(4):789-804. doi: 10.1177/1877718X251330993. Epub 2025 Apr 29. J Parkinsons Dis. 2025. PMID: 40302366
  • SPIRIT 2025 statement: updated guideline for protocols of randomized trials.
    Chan AW, Boutron I, Hopewell S, Moher D, Schulz KF, Collins GS, Tunn R, Aggarwal R, Berkwits M, Berlin JA, Bhandari N, Butcher NJ, Campbell MK, Chidebe RCW, Elbourne DR, Farmer AJ, Fergusson DA, Golub RM, Goodman SN, Hoffmann TC, Ioannidis JPA, Kahan BC, Knowles RL, Lamb SE, Lewis S, Loder E, Offringa M, Ravaud P, Richards DP, Rockhold FW, Schriger DL, Siegfried NL, Staniszewska S, Taylor RS, Thabane L, Torgerson DJ, Vohra S, White IR, Hróbjartsson A. Chan AW, et al. Nat Med. 2025 Jun;31(6):1784-1792. doi: 10.1038/s41591-025-03668-w. Epub 2025 Apr 29. Nat Med. 2025. PMID: 40295741 Review.
See all similar articles

References

    1. Wilson JE, Mart MF, Cunningham C et al (2020) Delirium. Nat Rev Dis Primers 6(1):90. 10.1038/s41572-020-00223-4 - PMC - PubMed
    1. American Psychiatric Association, DSM-5 Task Force (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, Inc., Arlington
    1. Welch C, McCluskey L, Wilson D et al (2019) Delirium is prevalent in older hospital inpatients and associated with adverse outcomes: results of a prospective multi-centre study on World Delirium Awareness Day. BMC Med 17(1):229. 10.1186/s12916-019-1458-7 - PMC - PubMed
    1. Gibb K, Seeley A, Quinn T et al (2020) The consistent burden in published estimates of delirium occurrence in medical inpatients over four decades: a systematic review and meta-analysis study. Age Ageing 49(3):352–360. 10.1093/ageing/afaa040 - PMC - PubMed
    1. Chen F, Liu L, Wang Y, Liu Y, Fan L, Chi J (2022) Delirium prevalence in geriatric emergency department patients: a systematic review and meta-analysis. Am J Emerg Med 59:121–128. 10.1016/j.ajem.2022.05.058 - PubMed

LinkOut - more resources