4AT Score

Suggests the presence of delirium.

4AT Delirium Score Calculator

4AT Delirium Score Calculator

A1: Alertness

Assess the patient’s level of alertness. If they are clearly abnormal (drowsy, stupor, coma, or agitated/hyperactive), score 4. If mildly sleepy (rouses to voice, then closes eyes), score 1. Otherwise, score 0.

A2: AMT4

Ask the patient their age, date of birth, the current place (e.g., hospital name, town), and the current year. Score 0 if 4-5 correct, 2 if 0-3 correct.

A3: Attention

Ask the patient to state the months of the year backwards, starting from December. Score 0 if 7 or more correct, 1 if less than 7 correct or untestable.

A4: Acute change or fluctuating course

Is there evidence of acute change or fluctuation in alertness, cognition, or other mental functions from the patient’s usual baseline, or has it fluctuated over the last 24 hours?

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