Approach to Altered Mental Status and Inpatient Delirium

Sara C LaHue; Vanja C Douglas

doi:10.1016/j.ncl.2021.08.004

Approach to Altered Mental Status and Inpatient Delirium

Neurol Clin. 2022 Feb;40(1):45-57. doi: 10.1016/j.ncl.2021.08.004.

Authors

Sara C LaHue¹, Vanja C Douglas²

Affiliations

¹ Department of Neurology, School of Medicine, University of California, San Francisco, CA, USA; Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA. Electronic address: Sara.LaHue@ucsf.edu.
² Department of Neurology, School of Medicine, University of California, San Francisco, CA, USA; Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.

Abstract

Altered mental status is a nonspecific diagnosis that encompasses a wide spectrum of disease and is frequently cited as a reason for both hospital admission and inpatient neurologic consultation. There are numerous etiologies of altered mental status, and so although many are facile with the workup of this potentially life-threatening entity, it can nevertheless be overwhelming. Our goal was to provide a practical framework embedded in a current, comprehensive review of the epidemiology, clinical evaluation, and management of undifferentiated altered mental status. We pay particular attention to the management of a critical yet underdiagnosed subtype of altered mental status: delirium.

Keywords: Altered mental status; Delirium; Elderly; Encephalopathy; Hospitalized; Inattention; Inpatient; Postoperative.

Publication types

Review

MeSH terms

Delirium* / diagnosis
Delirium* / epidemiology
Delirium* / etiology
Humans
Inpatients*

Grants and funding

R03 AG074035/AG/NIA NIH HHS/United States