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Table 2 Specific content of the Confusion Assessment Method

From: Efficiency of donepezil in elderly patients undergoing orthopaedic surgery due to underlying post-operative cognitive dysfunction: study protocol for a multicentre randomised controlled trial

The Confusion Assessment Method (CAM)

Feature 1

Acute change in mental status with a fluctuating course

Is there evidence of an acute change in mental status from the patient’s baseline? Did this behaviour fluctuate during the past day, that is, tend to come and go or increase and decrease in severity? This feature is usually obtained from a family member or nurse and is shown by positive responses.

Feature 2

Inattention

Do the patients have difficulty focusing attention, for example, being easily distractible, or having difficulty keeping track of what was being said?

Feature 3

Disorganized thinking

This feature is shown by a positive response to the following question: Was the patient’s thinking disorganized or incoherent, such as rambling or irrelevant conversation, unclear or illogical flow of ideas, or unpredictable switching from subject to subject?

Feature 4

Altered level of consciousness

Overall, how would you rate this patient’s level of consciousness? (alert [normal], vigilant [hyperalert], lethargic [drowsy, easily aroused], stupor [difficult to arouse], or coma [unarousable])

  1. The diagnosis of delirium by CAM requires the presence of features 1 and 2 and either 3 or 4