MDCalc

4 A’s Test for Delirium Screening

Diagnoses delirium in older patients.

Alertness

May ask patient to state name and address to help with rating
Age, date of birth, place (name of the hospital or building), current year

Attention

Instruct patient to list months in reverse order, starting at December

Acute change or fluctuating course

Evidence of significant change or fluctuation in mental status within the last 2 weeks and still persisting in the last 24 hours

Result:

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Advice

If delirium is diagnosed, identify and treat underlying cause.