4-DSD — 4-Delirium Superimposed on Dementia
2021A four-item assessment developed specifically for delirium superimposed on moderate-to-severe dementia. In one multicentre cohort, a cut-off of 5 or more had 80% sensitivity and 80% specificity; specificity was lower in the small severe-dementia subgroup.
80%
Sensitivity*
80%
Specificity*
n=134
Sample
Full name4-Delirium Superimposed on Dementia
Also known as4-DSD, 4 Delirium Superimposed on Dementia
PurposeDiagnostic assessment (episodic)
PopulationAdult
SettingGeneral / acute hospital
Items4
Administration~3 min
EvidenceSingle validation study
Reference typeOriginal validation study
Reference standardDSM-5
Validation samplen = 134
Cut-off / scoring≥5 of 12
Strengths＋ Designed specifically for moderate-to-severe dementia; includes acute change/fluctuation and function
Limitations− One principal validation cohort; specificity was 56% in the small severe-dementia subgroup (n=26)
ReferenceMorandi A, Grossi E, Lucchi E, et al. The 4-DSD: A New Tool to Assess Delirium Superimposed on Moderate to Severe Dementia. J Am Med Dir Assoc. 2021;22(7):1535-1542.e3. PMID 33823162
* Where shown, sensitivity/specificity are from the cited validation cohort and are not pooled estimates. Citation metadata was checked against PubMed or the publisher DOI record; a checked reference does not imply validation, study quality or endorsement. See the Methodology.