Objective: To evaluate the ability of simple bedside tests for attention to detect delirium in those with and without underlying neurodegenerative diseases, including Parkinson’s disease (PD) and dementia.
Background: Delirium is a serious acute neuropsychiatric condition of which altered attention and arousal are core features; it may also be associated with increased mortality. Impaired cognition is common on PD and dementia subtypes. However, no studies to date have evaluated the diagnostic accuracy of simple bedside tests in PD with delirium.
Method: Participants from two prospective delirium studies were pooled comprising 179 older adults, 30 PD and no cognitive impairment, 24 with Lewy body disease (LBD comprising PD dementia [PDD] or dementia with Lewy bodies [DLB]) and 16 with another dementia. Participants completed a standardised delirium assessment including tests of attention: digit span, Memorial Delirium Assessment Scale (MDAS) attention item and months of the year backwards (MOTYB). Delirium was diagnosed using the DSM-5 criteria. The diagnostic test accuracy of each measure of attention were assessed using receiver operating characteristic (ROC) curves and area under the curve (AUC).
Results: 21.7% participants had prevalent delirium on their first admission. Only selected attention measures detected delirium in PD (backwards digit span, MOTYB and MDAS attention) and dementia (MDAS attention only), while all tests were sensitive for delirium detection in older adults (p<0.01 for all). In PD and LBD and dementia, the optimal test for attentional dysfunction in delirium was the MDAS attention item with a cut-off of 0/1 (PD and LBD: AUC=0.84, sensitivity 68.2%, specificity 92.9%; dementia; AUC=0.78, sensitivity 68.1%, specificity 83.9%).
Conclusion: Simple bedside tests of attention could accurately detect delirium in older adults, PD and dementia; however, the optimal tests differed between groups. Combined attention and arousal scores increased diagnostic accuracy, which could have clinical utility to aid the identification of delirium in those with neurodegenerative disorders.
To cite this abstract in AMA style:
R. Lawson, S. Richardson, D. Kershaw, D. Davis, B. Stephan, L. Robinson, C. Brayne, L. Barnes, D. Burn, A. Yarnall, JP. Taylor, S. Parker, L. Allan. Evaluation of bedside tests of attention in delirium superimposed on Parkinson’s disease and dementia [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/evaluation-of-bedside-tests-of-attention-in-delirium-superimposed-on-parkinsons-disease-and-dementia/. Accessed June 15, 2025.« Back to MDS Virtual Congress 2021
MDS Abstracts - https://www.mdsabstracts.org/abstract/evaluation-of-bedside-tests-of-attention-in-delirium-superimposed-on-parkinsons-disease-and-dementia/