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PRINCIPLE 1: Cognitive screening

Patients aged 65 years and over will be screened for confusion on admission or within 24 hours of admission using a validated screening tool.

Undertake cognitive screening

Confusion is not a normal part of ageing (1,2).

Cognitive screening is the first step towards appropriate identification and management of older people with confusion presenting to hospital. Cognitive screening should be performed in conjunction with delirium risk screening.

Cognitive screening for older people is often overlooked during initial admission processes. This can lead to the assumption that any confusion identified during admission is related to dementia. As a result, the diagnosis of delirium is often missed.

Cognitive screening should be performed as part of the routine admission to a health care setting. It is useful for determining baseline cognitive status and identifying changes over time. However, cognitive screening cannot diagnose diseases such as dementia (1,2).

It is important to determine a premorbid level of functioning – or baseline – when comprehensively assessing an individual's cognition.

To do so, it may help to talk with their:

  • carer/s
  • General Practitioner
  • Aged Care Assessment Team (ACAT)
  • service providers (e.g. home care, care package provider, or a community nurse)
  • Residential Aged Care facilities.


  1. Christie J and Cunningham C. Caring for people with dementia in hospital settings. HammondCare, 2011.
  2. Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet. 2013.