4 AT score (4AT)

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Procedure

alertness
- Observe the patient. Note if drowsy or agitated,'
- if asleep, attempt to wake with speech or gentle touch on shoulder
- ask the patient to state their name & address
- scoring
  - normal, fully awake, alert, not agitated = 0
  - mildly sleepy, normal upon awakening (< 10 seconds) = 0
  - abnormal = 4
Abbreviated Mental Test - 4 (AMT4)
- age, date of birth, location (where are you?), current year.
- scoring
  - no mistakes = 0
  - 1 mistake = 1
  - 2 or more mistakes or untestable = 2
attention
- months of the year in backwards order, starting at December
  - prompt to what is month before December is permitted
- scoring
  - >= 7 months correct = 0
  - starts but scores <7 months or refuses to start = 1
  - untestable (dowsiness, attention deficit) = 2
acute change or fluctuating
- change or fluctuation in: alertness, cognition, other cognitive function (paranoia, hallucinations) arising over the last 2 weeks, still evident in last 24hrs
- scoring
  - no = 0
  - yes = 4

score >= 4: possible delirium +/- cognitive impairment
score 1-3: possible cognitive impairment
score = 0: delirium or severe cognitive impairment unlikely
- delirium still possible if information incomplete