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Pulling Back the Curtain on Hospital Dementia Detection: Validation of the Informant‐Based Clinical Dementia Rating
Márlon Juliano Romero Aliberti, Thiago Junqueira Avelino‐Silva, Kenneth E. Covinsky, Laiss Bertola, Regina Miksian Magaldi, Cynthia M. Boyd, Christopher R. Carpenter, Mônica Sanches Yassuda et al.. Journal of the American Geriatrics Society, 2025-05-02
Topic: Risk, prevention and care in population studies
Of 65 participants (mean age = 79.4 years; women = 54%), 34% had dementia and 32% had CIND. Compared to the gold standard, the informant-based CDR showed excellent diagnostic accuracy for detecting dementia (AUC = 0.92; 95% confidence interval [CI] = 0.86-0.98) and cognitive impairment (AUC = 0.93; 95% CI = 0.88-0.98), with a cutoff of ≥ 1 showing 98% specificity for dementia and a cutoff of ≥ 0.5 showing 98% sensitivity for cognitive impairment. Compared to the IQCODE-16, the informant-based CDR had similar performance in detecting dementia and a nonsignificant slight advantage in identifying cognitive impairment (AUC = 0.93 vs. 0.84, p = 0.069), reducing unrecognized cognitive impairment based on medical record documentation from 70% to 2%. Informant-based CDR is a valid and efficient tool for detecting dementia and cognitive impairment in hospitalized older adults, supporting early diagnosis and guiding multidisciplinary interventions in acute care. Its use in routine hospitals may help clinicians reduce undetected cognitive impairment, enhance decision making, and improve patient care.
Key findings
- Of 65 participants (mean age = 79.4 years; women = 54%), 34% had dementia and 32% had CIND.
- Compared to the gold standard, the informant-based CDR showed excellent diagnostic accuracy for detecting dementia (AUC = 0.92; 95% confidence interval [CI] = 0.86-0.98) and cognitive impairment (AUC = 0.93; 95% CI = 0.88-0.98), with a cutoff of ≥ 1 showing 98% specificity for dementia and a cutoff of ≥ 0.5 showing 98% sensitivity for cognitive impairment.
- Compared to the IQCODE-16, the informant-based CDR had similar performance in detecting dementia and a nonsignificant slight advantage in identifying cognitive impairment (AUC = 0.93 vs. 0.84, p = 0.069), reducing unrecognized cognitive impairment based on medical record documentation from 70% to 2%.
- Informant-based CDR is a valid and efficient tool for detecting dementia and cognitive impairment in hospitalized older adults, supporting early diagnosis and guiding multidisciplinary interventions in acute care.
- Its use in routine hospitals may help clinicians reduce undetected cognitive impairment, enhance decision making, and improve patient care.
Why it matters
In this cross-sectional study of hospitalised older adults, the informant-based Clinical Dementia Rating showed excellent accuracy for detecting dementia and cognitive impairment, reducing unrecognised cognitive impairment from 70% to 2%. It supports early diagnosis in acute care and does not test any treatment or cure.
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Study details
- Study designcross-sectional
- Participants65
- Effect sizeAUC = 0.92; AUC = 0.93
- Evidence strengthLow
How this study scored 54/100
Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 52 of the 96 points we could judge it on, which is 54 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American Geriatrics Society) |
| Journal's citation record | 3 / 4 | Journal of the American Geriatrics Society: journal h-index 344 (OpenAlex, 2026-10-29) |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 1 / 4 | 65 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 7 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 4.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 2 other studies in this library |
| Still being cited | 1 / 4 | Cited 7 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | 2 / 3 | Johns Hopkins University: institution h-index 2,306 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 8 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40317752) |
| Free to read | 2 / 2 | Free to read |
| Points | 52 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 52 of the 96 points we could judge it on is 54 out of 100. |
| Total | 54 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Aliberti, M. J. R., Avelino‐Silva, T. J., Covinsky, K. E., Bertola, L., Magaldi, R. M., Boyd, C. M., et al. (2025). Pulling Back the Curtain on Hospital Dementia Detection: Validation of the Informant‐Based Clinical Dementia Rating. Journal of the American Geriatrics Society. https://doi.org/10.1111/jgs.19494
Vancouver
Aliberti MJR, Avelino‐Silva TJ, Covinsky KE, Bertola L, Magaldi RM, Boyd CM, et al. Pulling Back the Curtain on Hospital Dementia Detection: Validation of the Informant‐Based Clinical Dementia Rating. Journal of the American Geriatrics Society. 2025. doi:10.1111/jgs.19494. PMID: 40317752.
BibTeX
@article{aliberti2025-40317752,
author = {Aliberti, Márlon Juliano Romero and Avelino‐Silva, Thiago Junqueira and Covinsky, Kenneth E. and Bertola, Laiss and Magaldi, Regina Miksian and Boyd, Cynthia M. and Carpenter, Christopher R. and Yassuda, Mônica Sanches and others},
title = {{Pulling Back the Curtain on Hospital Dementia Detection: Validation of the Informant‐Based Clinical Dementia Rating}},
journal = {Journal of the American Geriatrics Society},
year = {2025},
doi = {10.1111/jgs.19494},
pmid = {40317752},
url = {https://doi.org/10.1111/jgs.19494}
}
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