Delirium Outside ICU

Acute fluctuating disturbance of attention + cognition + consciousness. Two main subtypes: • Hyperactive: restless, agitated, hallucinations, delusions, wandering. • Hypoactive: drowsy, withdrawn, slow responses (often missed — worse prognosis). • Mixed. SCREEN with 4AT (Alertness, AMT4 — age / DOB / place / current year, Attention — months backwards, Acute Change / Fluctuating Course): • Score 0: delirium unlikely. • Score 1–3: cognitive impairment. • Score ≥4: possible delirium + cognitive impairment. CAM (Confusion Assessment Method) alternative. Distinguish from dementia: delirium is acute (hours-days); dementia is gradual (months-years). Delirium can be superimposed on dementia.