Positive delirium screenings often lead to inappropriate dementia diagnoses among new residents of skilled nursing facilities — even in those who are cognitively healthy, investigators contend.

The researchers analyzed data for more than 1.2 million Medicare enrollees who were admitted  from acute care to a nursing home and had no prior dementia diagnosis. Screenings for delirium were performed as part of the federally mandated Minimum Data Set assessment using the validated Confusion Assessment Method.

Residents who received positive delirium screening results on admission were up to six times more likely to receive a diagnosis of Alzheimer’s disease or related dementias than their peers with a negative result, the analysis revealed.

At highest risk for a dementia diagnosis were residents in their first 30 days of stay and — counterintuitively — those with the least cognitive impairment, reported researcher Becky A. Briesacher, Ph.D., of Northeastern University, Boston. This suggests that many of these diagnoses are potentially inappropriate, she said.

Residents who screened positive for delirium had nearly three times the risk of receiving a dementia diagnosis that same day. Further, residents who were cognitively intact or had mild cognitive impairment were six times more likely to receive a diagnosis of dementia when compared with their peers who tested negative.

Full findings were published in the Journal of the American Geriatrics Association.