Larner Assistant Professor of Medicine Tara Scribner, M.D., an internal medicine hospitalist at the University of Vermont Medical Center, was interviewed in Medscape about signs that a hospital patient may have lost some mental acuity.
“Evaluation of orientation and level of awareness is a core component of any hospitalist’s daily evaluation,” she said. “Beyond this, a broader assessment of executive function and functional abilities always occurs at some point during a hospital admission as discharge location and situation depends on this.”
While it’s relatively easy to identify signs of dementia using information from collateral sources, she also noted it’s often difficult to determine whether a patient is experiencing progressive dementia or a more acute encephalopathy, such as delirium, if collateral sources are not available.
“Once a baseline has been established, hospitalists are in a unique position to identify subtle and acute shifts in mental acuity over the course of a hospital stay,” Scribner said. “Unlike our primary care colleagues, who are well positioned to observe for signs of dementia, we see our patients on a daily basis, sometimes more than once daily, and can track changes which occur over a matter of hours or days.”