Care Needs for Patients Screened Positive for Cognitive Impairment and Delirium: A Cross-Sectional Observational Study

Alison M Mudge; Sarah Anderson; Aparna Arjunan; Marguerite Byrnes; Margaret Cahill; Alison Craswell; Joel Dulhunty; Amanda Fox; Nicole C Gavin; Peter Lawrenson; Karen Lee-Steere; Hui-Shan Lin; Andrew Teodorczuk; Elise Treleaven; Laura White; Chloe Yap

doi:10.1111/jan.70530

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Care Needs for Patients Screened Positive for Cognitive Impairment and Delirium: A Cross-Sectional Observational Study

Journal article

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Care Needs for Patients Screened Positive for Cognitive Impairment and Delirium: A Cross-Sectional Observational Study

Alison M Mudge, Sarah Anderson, Aparna Arjunan, Marguerite Byrnes, Margaret Cahill, Alison Craswell, Joel Dulhunty, Amanda Fox, Nicole C Gavin, Peter Lawrenson, …

Journal of Advanced Nursing, Vol.Advanced access

05-Mar-2026

DOI: https://doi.org/10.1111/jan.70530

PMID: 41787740

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Abstract

dementia

cognitive dysfunction

hospitalisation

nursing care

delirium

Aim To describe the point prevalence of cognitive impairment in hospitalised adults and evaluate the association with care needs and perceived risks of complications. Design Multi-site cross-sectional study on a single day in May 2023. Methods Trained clinician auditors screened adult inpatients in acute medical, surgical, oncology, geriatric, mental health, convalescent, and rehabilitation wards for cognitive impairment using the 4AT in seven healthcare facilities and recorded need for support with basic activities of daily living, incontinence, and perceived risks of complications (falls, pressure injuries, and malnutrition). Data were summarised and compared across 4AT categories, and the strength of association between 4AT and each outcome was estimated using multivariable regression models. Results Data were available for 1145 inpatients on 68 wards (mean age 68 years [SD = 18], 583 [58.9%] female, 449 [39.2%] on acute medical units). Cognitive impairment (4AT of 1 or more) was identified in 482 (42.1%) participants. Participants with 4AT 1–3 had 2.0–3.6 times the odds of need for supervision or assistance with activities of daily living, while those with 4AT 4 or more had 2.9–5.3 times the odds of need for assistance. Conclusion Cognitive impairment is very common in adult inpatients and is associated with significantly higher physical care needs. Implications for the Profession and Patient Care Hospital care models must support staff to address the higher care needs in people with cognitive impairment to protect a large patient group from hospital-acquired harm. Patient or Public Contribution No patient or public contribution. Reporting Method This study adheres to the STROBE reporting guidelines.

Details

Title: Care Needs for Patients Screened Positive for Cognitive Impairment and Delirium: A Cross-Sectional Observational Study
Authors: Alison M Mudge (Corresponding Author) - The University of Queensland
Sarah Anderson - Metro North Health (Australia)
Aparna Arjunan - Metro North Health (Australia)
Marguerite Byrnes - Caboolture Hospital (Australia)
Margaret Cahill - Royal Brisbane and Women's Hospital
Alison Craswell - University of the Sunshine Coast
Joel Dulhunty - The University of Queensland
Amanda Fox - Queensland University of Technology
Nicole C Gavin - Metro North Health (Australia)
Peter Lawrenson - Metro North Health (Australia)
Karen Lee-Steere - Queensland Health
Hui-Shan Lin - Metro North Health (Australia)
Andrew Teodorczuk - The University of Queensland
Elise Treleaven - Royal Brisbane and Women's Hospital
Laura White - Prince Charles Hospital
Chloe Yap - Metro South Health
Publication details: Journal of Advanced Nursing, Vol.Advanced access
Publisher: Wiley-Blackwell Publishing Ltd.
DOI: 10.1111/jan.70530
ISSN: 1365-2648
PMID: 41787740
Copyright note: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2026 The Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd.
Data Availability: The data that support the findings of this study are available on reasonable request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
Organisation Unit: Healthy Ageing Research Cluster; School of Health - Nursing
Language: English
Record Identifier: 991214281402621
Output Type: Journal article

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