Altered Mental Status

Quick Confusion Scale

  • The quick confusion scale in the ED: comparison with the mini-mental state examination. [Reference]
  • Validation of the Quick Confusion Scale for mental status screening in the emergency department [Reference]

Quick Confusion Scale

Comparing Delirium and Dementia

Delirium Dementia
Development SuddenOften with a definite onset SlowUsually uncertain onset
Cause Most often associated with systemic disruption such as infection, dehydration, or drugs (ingestion/withdrawal) Usually a brain disorder, such as Alzheimer’s disease, vascular dementia, or Lewy body dementia
Main early symptom Inability to pay attention Loss of memory, especially recent events
Effect at night Nearly always worse Sometimes worse
Level of alertness (consciousness) Impaired to varying degrees, can vary from being hyperalert to sluggish Normal until late stages
Orientation to surroundings Varies Impaired
Effect on language Slowed speech, often with incoherent and inappropriate language Sometimes difficulty finding the right word
Memory Varies LostEspecially for recent events
Progression Causes variations in mental function people are alert one moment and sluggish and drowsy the next Slowly progresses, gradually but eventually greatly impairing all mental functions
Duration Days to weeks, sometimes longer Almost always permanent
Need for treatment Immediate Needed but less urgently
Effect of treatment Usually reverses the losses May slow progression but cannot reverse or cure the disorder


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