Which assessment method is used to diagnose delirium in hospitalized older adults?

• A. Confusion Assessment Method (CAM)
• B. MMSE
• C. Confusion Assessment Method (CAM) or CAM-ICU
• D. Geriatric Depression Scale

Answer: (C)

Delirium in hospitalized older adults is diagnosed with a brief, validated bedside tool that zeroes in on acute changes in attention and cognition. The Confusion Assessment Method (CAM) is the standard approach for non-ICU inpatients, while CAM-ICU adapts the same criteria for patients in the ICU, including those who are intubated. These tools focus on four key features: acute onset and a fluctuating course, inattention, disorganized thinking, and altered level of consciousness; delirium is identified when the first two are present along with either the third or the fourth feature. They’re specifically designed to be quick and accurate in acute care settings, making them the best options for diagnosing delirium at the bedside. The MMSE, while useful as a general cognitive screen, is not designed to detect the acute, fluctuating attention changes that define delirium and can be confounded by baseline dementia. The Geriatric Depression Scale assesses mood and is not used to diagnose delirium. Therefore, using CAM or CAM-ICU provides the most reliable method for identifying delirium in hospitalized older adults.