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Tests and diagnosis
By Mayo Clinic staffA doctor will diagnose delirium based on the answers to questions about a person's medical history, tests to assess mental status and the identification of possible contributing factors. An examination may include the following:
- Mental status assessment. A doctor starts by assessing awareness, attention and thinking. This can be done informally through conversation, or more formally with tests or screening checklists that assess mental state, confusion, perception and memory.
- Physical and neurological exams. The doctor will perform a physical exam, checking for signs of dehydration, infection, alcohol withdrawal and other problems. The physical exam can also help detect underlying disease. Delirium may be the first or only sign of a serious condition, such as respiratory failure or heart failure. A neurological exam — checking vision, balance, coordination and reflexes — can help determine if a stroke or another neurological disease is causing the delirium.
- Other possible tests. If the cause or trigger of delirium can't be determined from the medical history or exam, the doctor may order blood, urine and other diagnostic tests. Brain-imaging tests, which require a certain degree of cooperation from the person being examined, are generally used when a diagnosis can't be made with other available information.
References
- Delirium. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Dec. 8, 2009.
- Inouye SK. Delirium in older persons. New England Journal of Medicine. 2006;354:1157.
- Gleason OC. Delirium. American Family Physician. 2003;67:1027.
- Saxena S, et al. Delirium in the elderly: A clinical review. Postgraduate Medical Journal. 2009;85:405.
- Francis J, et al. Diagnosis of delirium and confusional states. http://www.uptodate.com/index.html. Accessed Dec. 8, 2009.
- Potter J, et al. The prevention, diagnosis and management of delirium in older people: Concise guidelines. Clinical Medicine. 2006;6:303.
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