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A 4-DSD cutoff score ≥5 had a sensitivity of 80% and specificity of 80% with a positive predictive value (PPV) of 67% and a negative predictive value (NPV) of 89%. In the subgroup with moderate-severe dementia (n=108), the sensitivity and the specificity were 79% and 82%, respectively, with a PPV and NPV of 62% and 92%. In the subgroup with severe dementia (n=26) the sensitivity was 82% and the specificity 56% with a PPV of 78% and a NPV of 63%. The availability of a specific tool to detect delirium in patients with moderate-severe dem