COSMIN database

Delirium scales: A review of current evidence

Adamis, D., Sharma, N., Whelan, P. J., and Macdonald, A. J.
OBJECTIVES: Delirium is a common neuropsychiatric condition with many adverse outcomes in elderly populations including death. Despite this, it is often misdiagnosed and mistreated. A number of scales can be used to detect delirium. We review scales that have been used in delirium studies and report their psychometric properties.

METHOD: An extensive MEDLINE database search and subsequent examination of reference lists was conducted to identify the various delirium scales that have been designed, primarily for use in the elderly.

RESULTS: Twenty-four scales were identified. Delirium instruments differed according to the classification system they were based on, length of time to administer, the rater and whether they were screening scales or measured symptom severity. The psychometric properties of each scale is reported.

CONCLUSION: A large number of scales exist, but not all are properly evaluated in terms of psychometric properties, and there is not unanimity about which scale is the best. However, a small number of scales may be considered already to be robust and useable: the CAM, the DRS, the MDAS and the NEECHAM.
Aging Ment Health
1364-6915 (Electronic)
Publication year:
Symptom status:
Cognitive/mental state
Adults (18-65)
Seniors (65+)
Mental and behavioural disorders and related symptoms
PRO / non-PRO:
Non-patient Reported Outcome
Type of measurement instrument:
4 - Performance-based tests
6 - Clinical rating scales
7 - Observations
Abnormal Signature Test
Bedside Confusion Scale
CAC-A - Clinical Assessment of Confusion-A
CAC-B - Clinical Assessment of Confusion-B
CAM - Confusion Assessment Method
CDT - Clock Drawing Test
CRS - Confusion Rating Scale
CSE - Confusion State Evaluation
CTD - Cognitive Test for Delirium
DAS - Delirium Assessment Scale
Delirium Writing Test
DI - Delirium Index
DOM - Delirium-O-Meter
DOS - Delirium Observation Screening Scale
DRS - Delirium Rating Scale
DRS-R-98 - Delirium Rating Scale-Revised-98
D-Scale - Delirium Scale
DSI - Delirium Symptom Interview
DSS - Delirium Severity Scale
MDAS - Memorial Delirium Assessment Scale
NEECHAM Confusion Scale   
Nu-DESC - Nursing Delirium Screening Scale
OBS - Organic Brain Syndrome
SDC - Saskatoon Delirium Checklist
VAS-C - Visual Analog Scale for Acute Confusion