What is the scoring basis of the CAM delirium assessment?

• A. CAM relies on self-report of confusion.
• B. CAM requires chronic onset and inattention plus disorganized thinking or altered level of consciousness.
• C. CAM requires acute onset and inattention; disorganized thinking or altered level of consciousness is not required.
• D. CAM is a brief mood screen.

Answer: (C)

The CAM delirium assessment is based on a few key features that together indicate delirium. Delirium is identified when there is an acute change in mental status with fluctuations, and the person is inattentive. In addition to these two core symptoms, at least one of two other features must be present: disorganized thinking or an altered level of consciousness. So the scoring basis is: acute onset with inattention, plus either disorganized thinking or altered level of consciousness. This combination distinguishes delirium from other conditions and underlines why a simple self-report or a mood screen isn’t sufficient.