Freter et al reported the Delirium Elderly At-Risk (DEAR) instrument to identify an elderly patient at risk for post-operative delirium. The authors are from Dalhousie University in Halifax, Nova Scotia.

Risk factors for post-operative delirium:

(1) cognitive impairment (may be detected by the MMSE or clock-drawing test)

(2) substance use disorder (> 3 alcoholic drinks per week or use of a benzodiazepine > 3 times per week)

(3) age >= 80 years

(4) dependence in >= 1 activities of daily living (ADL)

(5) sensory impairment (requiring a hearing aid or complaining of very poor vision)


The score is the number of risk factors present.



minimum number of risk factors: 0

maximum number of risk factors: 5

A cut-off of 2 or 3 can be used to identify a patient at increased risk for postoperative delirium.

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