Description

The Memorial Delirium Assessment Scale (MDAS) is an assessment tool used to detect and evaluate disturbances of consciousness (delirium) in patients, typically in settings such as intensive care units (ICUs) or palliative care. The MDAS helps assess both the severity and prognosis of delirium.

Analysis

The MDAS consists of 11 items (not 10 as initially stated), each addressing different aspects of delirium. These include:
Level of Consciousness – Assesses alertness and ability to maintain attention.
Comprehension – Evaluates the patient’s ability to understand and follow instructions.
Aphasia – Screens for speech disturbances such as difficulty in expression or understanding.
Sleep Disturbances – Measures changes in the patient’s sleep patterns.
Delusional Thinking – Assesses the presence of delusional or hallucinatory thoughts.
Memory Loss – Evaluates the extent of amnesia or memory difficulties.
Disorientation – Screens for confusion and disorientation.
Agitation – Measures levels of anxiety or restlessness.
Unusual Behavior – Assesses for unpredictable or abnormal behaviors.
Emotional Lability – Evaluates emotional responses to various situations.
Psychomotor Disturbance – Includes hyperactive or hypoactive motor activity.

Objective

The main objectives of the MDAS are:
Detection and Evaluation: To detect and assess the severity of delirium in patients.
Treatment Guidance: To aid in guiding treatment and management of delirium.
Monitoring Progression: To monitor the course of delirium and evaluate patient response to treatment.

Scoring

Administration: The clinician evaluates the patient based on 11 scales, each representing a distinct domain of delirium.
Rating: Each item is scored from 0 to 3, where higher scores indicate more severe symptoms.
Total Score: The total score is obtained by summing the individual item scores. A score of 13 or above typically indicates the presence of delirium.

References

McNicoll, L., Inouye, S. K., Jones, R., & Fridman, C. (2003). The Memorial Delirium Assessment Scale: A new tool for assessing delirium. Journal of Palliative Medicine, 6(4), 617–624.
Inouye, S. K., van Dyck, C. H., Alessi, C. A., Balkin, S., Siegal, A., & Horwitz, R. I. (1990). The Confusion Assessment Method: A new method for detecting delirium. JAMA, 263(20), 3216–3221.
Borson, S., Scanlan, J. M., Watanabe, J., & Tu, S. P. (2003). The Mini-Cog: A cognitive tool for dementia screening in multi-lingual elderly. Journal of the American Geriatrics Society, 51(5), 679–687.