Altered mental status in older patients in the emergency department

Clin Geriatr Med. 2013 Feb;29(1):101-36. doi: 10.1016/j.cger.2012.09.005.


Altered mental status is a common chief compliant among older patients in the emergency department (ED). Acute changes in mental status are more concerning and are usually secondary to delirium, stupor, and coma. Although stupor and coma are easily identifiable, the clinical presentation of delirium can be subtle and is often missed without actively screening for it. For patients with acute changes in mental status the ED evaluation should focus on searching for the underlying etiology. Infection is one of the most common precipitants of delirium, but multiple causes may exist concurrently.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Coma / diagnosis
  • Coma / epidemiology
  • Coma / etiology
  • Delirium / diagnosis
  • Delirium / epidemiology
  • Delirium / etiology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Emergency Service, Hospital*
  • Geriatric Assessment*
  • Humans
  • Mental Disorders / diagnosis
  • Mental Disorders / epidemiology
  • Mental Disorders / etiology*
  • Mental Status Schedule
  • Risk Factors
  • Severity of Illness Index
  • Stupor / diagnosis
  • Stupor / epidemiology
  • Stupor / etiology