4 A’s Test for Delirium Screening
Diagnoses delirium in older patients.
When to Use
Pearls/Pitfalls
Why Use
Normal
0Mild sleepiness for <10 seconds after waking, then normal
0Clearly abnormal
+4No mistakes
01 mistake
+1≥2 mistakes or untestable
+2Lists ≥7 months correctly
0Starts but lists <7 months, or refuses to start
+1Untestable (cannot start because unwell, drowsy, inattentive)
+2No
0Yes
+4Result:
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