Confusion assessment method (CAM) for the diagnosis of delirium
The diagnosis of delirium requires the presence of features 1 AND 2 plus either 3 OR 4.
Feature |
Assessment |
| 1. Acute onset and fluctuating course | Usually obtained from a family member or nurse and shown by positive responses to the following questions:
“Is there evidence of an acute change in mental status from the patient’s baseline?”; “Did the abnormal behavior fluctuate during the day, that is, tend to come and go, or increase and decrease in severity?” |
| 2. Inattention | Shown by a positive response to the following:
“Did the patient have difficulty focusing attention, for example, being easily distractible or having difficulty keeping track of what was being said?” |
| 3. Disorganized thinking | Shown by a positive response to the following:
“Was the patient’s thinking disorganized or incoherent, such as rambling or irrelevant conversation, unclear or illogical flow of ideas, or unpredictable switching from subject to subject?” |
| 4. Altered level of consciousness | Shown by any answer other than “alert” to the following: |
| “Overall, how would you rate this patient’s level of consciousness?” | |
| Normal = alert | |
| Hyperalert = vigilant | |
| Drowsy, easily aroused = lethargic | |
| Difficult to arouse = stupor | |
| Unarousable = coma |