MDAS — Memorial Delirium Assessment Scale
10-item clinician-rated severity scale of delirium (Breitbart 1997). Each item 0–3. Total 0–30. Cut-off ≥7/10 sensitive for delirium; severity bands inform escalation.
Score interpretation
→ Continue baseline care. Repeat MDAS daily in at-risk inpatient (≥75 yr, post-op, ICU, advanced cancer).
→ TIME bundle: Triggers (sepsis, electrolytes, glucose, hypoxia, retention, constipation, drugs); Investigate; Manage; Engage family. Non-pharmacological first-line: orientation, sleep hygiene, glasses/hearing aids, mobilise, limit nocturnal disturbance.
→ Continue TIME bundle. Cautious low-dose haloperidol 0.5 mg PO/IM (avoid in PD/LBD — use quetiapine 12.5–25 mg); short course only. Move to side room with familiar carer if possible.
→ Senior medical and nursing review. Specialist mental-health-of-older-adults (MHOA) liaison. Address risk to self / staff. Consider quetiapine, midazolam SC in palliative context. End-of-life discussion if dying patient — terminal restlessness common; midazolam SC + levomepromazine for refractory agitation.
Interpretation bands for the MDAS. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Acute Behavioural Disturbance / Rapid Tranquillisation · RCEM 2022; RCPsych 2022; NICE NG10
- Self-Harm Presentation · NICE NG225 (2022)
- Capacity Assessment (Mental Capacity Act) · MCA 2005; Code of Practice
- Acute Psychosis Management · NICE CG178 2014
- Depression Management · NICE CG90 2022
- Lithium Therapy Monitoring · NICE CG185
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.