Mental incapacity in a hospitalized patient may go unrecognized, especially if the patient was competent prior to being admitted.

Risk factors for transient mental incapacity during a hospitalization:

(1) older age

(2) delirium

(3) drug-induced cognitive impairment

(4) other adverse drug effects

(5) disorders affecting the brain (stroke, cardiac arrest, head injury, etc)

(6) acute illness

(7) metabolic disorders

(8) hypoxemia and/or hypercarbia

(9) borderline mental competence prior to the admission

(10) sleep deprivation

(11) withdrawal reaction

(12) adverse psychiatric response to illness

(13) severe chronic illness


A close family member may be the first person to recognize that there may be a problem.


A patient in the hospital should be evaluated for mental competence prior to making an important decision.


Differential diagnosis:

(1) inability to speak the local language well

(2) limited intellectual capacity

(3) disagreeing with what a healthcare provider wants to do

To read more or access our algorithms and calculators, please log in or register.