Validation of the Chinese version of the delirium diagnostic tool-provisional (DDT-Pro) among the older adults in the community

Objective To validate the Chinese version of the DDT-Pro and to define its cutoffs for delirium and for subsyndromal delirium in community-dwelling older adults. Methods This cross-sectional study included 591 participants. We determined the DDT-Pro cutoffs for best sensitivity, best specificity, or high combined sensitivity-specificity in delirium and subsyndromal delirium assessment. Results The ROC curve analysis of the DDT-Pro using the DSM-5-TR and the Delirium Rating Scale-Revised-98 (DRS-R98) as diagnostic standards displayed AUCs of 0.93 and 0.86. The ≤ 7 cutoff of the DDT-Pro is for detecting even SSD, the ≤ 6 cutoff favors sensitivity for delirium screening and is recommended for routine use, and the ≤ 5 cutoff favors specificity and has high combined sensitivity-specificity. The ≤ 6 cutoff had 95.35% sensitivity and 81.75% specificity for DSM-5-TR delirium, while the sensitivity and specificity for DRS-R98 delirium were 82.14% and 82.24%. The DDT-Pro displayed excellent inter-rater reliability in this sample, as well as high correlation with the DRS-R98 Severity scale in patients with DSM-5-TR delirium. Conclusion The Chinese DDT-Pro is valid and reliable for assessing delirium and its severity, with high screening performance at the ≤ 6 cutoff and other cutoff options for more specific diagnosis or for subsyndromal delirium detection.