The manuscript "Care needs for patients with cognitive impairment and
delirium: a multi-site cross-sectional observational study" is well presented. Appreciate the authors efforts in highlighting the focus on patient care needs and quantifying it using other tools in clinical practice (4AT).

Few suggestions:
1. As reported in limitations: 4AT is not a gold standard tool for cognitive impairment or delirium, and is a screening tool. Suggest rephrasing the title as "Care needs for patients screened positive for CI and delirium...."
2. I would expect a future direction statement that I read between the lines here - as interventions including family caregivers, and additional healthcare caregivers will benefit the patient care/ outcomes and should be further studied.
3. Please report in the point prevalence study, when was the 4AT usually completed: On hospital admission, within 48 hours, or at what frequency - was it done daily, or twice daily or only once at one point during hospitalization.

Overall excellent work trying to quantify and correlate patient care needs with a routinely used screening tool.

Thank you for addressing my comments and considering the suggestions. Appreciate the authors work and effort in patients with cognitive impairment and delirium.