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

DevelopmentSuddenOften with a definite onsetSlowUsually uncertain onset
CauseMost 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 symptomInability to pay attentionLoss of memory, especially recent events
Effect at nightNearly always worseSometimes worse
Level of alertness (consciousness)Impaired to varying degrees, can vary from being hyperalert to sluggishNormal until late stages
Orientation to surroundingsVariesImpaired
Effect on languageSlowed speech, often with incoherent and inappropriate languageSometimes difficulty finding the right word
MemoryVariesLostEspecially for recent events
ProgressionCauses variations in mental function people are alert one moment and sluggish and drowsy the nextSlowly progresses, gradually but eventually greatly impairing all mental functions
DurationDays to weeks, sometimes longerAlmost always permanent
Need for treatmentImmediateNeeded but less urgently
Effect of treatmentUsually reverses the lossesMay slow progression but cannot reverse or cure the disorder


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