Acute Onset

Definition: Alteration in mental status from patient's baseline (e.g. attention, orientation, orientation, cognition) that was new or worse for this patient, usually happens over hours to days.

How to Assess:

Baseline cognitive assessments, such as the Mini-Cog, Abbreviated Mental Test or Mini Mental State Examination, should be performed as part of routine hospital admissions on all older people. This assessment should be repeated when:

  • There is a sudden change in behaviour or cognition
  • Abrupt decline in Activities of Daily Living performance

"Reference: Inouye SK, vanDyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: The Confusion Assessment Method. A new method for detection of delirium. Ann Intern Med. 1990; 113: 941-948. Confusion Assessment Method: Training Manual and Coding Guide, Copyright 2003, Sharon K. Inouye, M.D., MPH. Not to be reproduced without permission. Instructions for correct usage available at the Hospital Elder Life Program (HELP) website Linked to another web site, or on request from Dr. Sharon Inouye.