CRITERIA | DESCRIPTION |
---|---|
1. Acute onset and fluctuating course | Is there evidence of an acute change in the patient’s mental status? Did this behaviour fluctuate during the past day—ie, come and go or increase and decrease in severity? (Usually requires information from family members or caregivers) |
2. Inattention | Does the patient have difficulty focusing?—eg, are they easily distracted or do they have difficulty keeping track of what is being said? (Inattention can be detected by the digit span test or asking for the days of the week to be recited backward) |
3. Disorganized thinking | Is the patient’s speech disorganized or incoherent, such as rambling or irrelevant conversation, unclear or illogical flow of ideas, or unpredictable switching between subjects? (Disorganized thinking and sleepiness can also be detected during conversation with the patient) |
4. Altered level of consciousness | Overall, would you rate this patient’s level of consciousness as alert (normal), vigilant (hyperalert), lethargic (drowsy, easily aroused), stupor (difficult to arouse), or coma (cannot be roused)? (All ratings except alert are scored as abnormal) |
Data from Inouye et al.21