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Title: Differentiating Delirium from Dementia

Category: Neurology

Keywords: delirium, dementia, CAM, MMSE (PubMed Search)

Posted: 7/2/2008 by Aisha Liferidge, MD (Updated: 7/21/2026)

  • The Confusion Assessment Method (CAM) and Mini-Mental State Exam (MMSE)  can be used in combination to effectively differentiate delirium from dementia, respectively.
  • CAM relies on observations by family members, caregivers, and clinicians to assess the following four symptoms:
    1. acute confusional onset
    2. inattention
    3. disorganized thinking
    4. ltered level of consciousness
  •  

  • Using CAM, the diagnosis of delirium requires the presence of both the first and second features, plus one of the two other features.
  • CAM is 95-100% sensitive and 95% specific for diagnosing delirium in the elderly.
  • MMSE is not a diagnostic tool but identifies cognitive impairment suggestive of delirium by assessing orientation, short-term memory, calculation ability, and language (score 18-26 = mild dementia).
  • A positive CAM and an MMSE score of > 25 is predictive of delirium.
  •  


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