Time spent in sedentary behaviour (sitting/lying down) has recently emerged as an important topic. Too much time spent in sedentary behaviours is linked with ill health and mortality. This seems to be independent of physical activity: a short burst of activity such as an exercise class will not offset the detrimental health effects of many hours sitting. Research suggests that sedentary behaviour is particularly common in stroke survivors who may spend up to 80% of their waking day sitting or lying down. Interventions to reduce sitting time have enormous potential, would be low cost and may be more achievable than a structured exercise programme, particularly in stroke survivors afraid of another stroke or falling.

Aims & Objectives

The aim of this study is to investigate whether a simple screening tool for delirium, that has been shown to be reliable in the detection of delirium in the hospital setting, might have utility in the detection of delirium as part of routine care in (UK) care homes, and whether it can be used to assess delirium severity.


The DOSS study is a Prospective observational study. Participating care home residents from four care homes in Leeds / Bradford will be assessed daily for delirium with the DOSS. Diagnostic accuracy of the DOSS for the detection of delirium will be tested against the Confusion Assessment Method completed by trained research assistants. Data collection will occur over nine months.
A reliable method of routine delirium detection in care homes may reduce the impact of an episode of delirium on individuals, their families, and care home staff, offering substantial benefits for the health economy and the wider NHS. Reliable detection of delirium in long-term care settings could form the basis for future delirium research and make delirium a feasible outcome measure for frail older people in this setting.


Teale EA, Munyombwe T, Siddiqi N, Schuurmans M, Young J. A prospective observational study to investigate utility of the Delirium Observational Screening Scale (DOSS) to detect delirium in care home residents. Age and Ageing 2018;47(1):56-61.

Teale E, Young J, Siddiqi N, Munyombwe T, Harrison J, Schuurmanns M. Study protocol: Investigation of the Delirium Observation Screening Scale (DOSS) for the routine detection of delirium in the care home setting: a prospective cohort study. BMJ Open 2016;6(6):e009615

Partners & Collaborators


Teale E, Young J, Schuurmans M, Siddiqi N, Munyombwe T.


April 2014 – March 2016

Funding agency

National Institute for Health and Care Research (NIHR)

Further information

For further information contact Dr Elizabeth Teale

This report is independent research funded by the National Institute for Health and Care Research (Research for Patient Benefit Programme, Investigation of the Delirium Observation Screening Scale (DOSS) for the routine detection of delirium in the Care Home Setting: The DOSS study, PB-PG-1112-29068. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.