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CAM confusion assessment test for diagnosis of delirium

see also:

General points

  • Ensure the patient is wearing glasses and/or hearing aids if required and assess the need for an interpreter.
  • Daily testing may be indicated during hospital admission
  • The diagnosis of delirium requires the presence of features 1 and 2 and either 3 or 4.

CAM assessment test

feature 1:
  • Acute onset and fluctuating course
  • Information usually obtained from positive responses from family / carers when asked:
    • Questions:
      1. Was there an acute or sudden change in the person’s mental status / the way s/he usually is?
      2. Did the abnormal / strange behaviour fluctuate during the day / come and go / increase and decrease in severity?
feature 2:
  • Inattention
    • Did the person have difficulty focusing attention?
    • Ie. Easily distractible or having difficulty keeping track
feature 3:
  • Disorganised thinking
    • Was the person’s thinking disorganised or incoherent, such as rambling or irrelevant conversation, unclear or illogical flow of ideas or unpredictable switching from one subject to another?
feature 4:
  • Altered Level of Consciousness
    • Overall, how would you rate the person’s level of consciousness? Alert / normal, vigilant / hyper-alert, drowsy, easily aroused, stupor / difficult to arouse or coma / unrousable.


  • Inouye SK1)
Inouye SK, et al Ann Intern Med. 1990; 113:941-8
n_test_cam.txt · Last modified: 2010/04/06 21:05 (external edit)