What Is Altered Mental Status?

Altered mental status (AMS) refers to a change in a person's level of consciousness, awareness, and responsiveness. It's a broad term used in healthcare to describe a range of conditions where an individual's mental state deviates from what is considered normal for them. AMS can manifest in various ways, including:

Confusion: The person may have difficulty thinking clearly, following instructions, or understanding their surroundings. Disorientation: They may be unsure of where they are, what time it is, or who they are. Agitation or restlessness: The person may appear unusually agitated, fidgety, or unable to stay still. Lethargy or drowsiness: They may be excessively sleepy or difficult to arouse. Unresponsiveness: In severe cases, the person may not respond to stimuli or may only respond minimally. AMS can be caused by a wide range of factors, including medical conditions (like infections, metabolic disorders, or neurological problems), drug or alcohol intoxication, head injuries, and various other underlying health issues. It can be an important sign of a serious underlying problem and often requires prompt medical evaluation and treatment. If someone is experiencing altered mental status, it is crucial to seek immediate medical attention to determine the cause and provide appropriate care. What Is an Altered Mental Status? Altered mental status (AMS) is a general term referring to a change to your average mental function. Altered mental status isn’t a specific diagnosis; it’s a symptom of a broader problem. It is a broad term for a range of neurological symptoms. Types of Altered Mental Status Medical providers divide altered mental status into three types: delirium, dementia, and psychosis: Delirium. Delirium is a change in mental function that often results in confusion and lack of awareness of the environment. Symptoms of delirium often set in rapidly. Dementia. Dementia is a decline in mental function that results in difficulty remembering things and trouble thinking or making decisions. The CDC estimates that there are about five million adults over the age of 65 with dementia. Though dementia is commonly the result of aging, other factors can cause it to occur in younger individuals. Dementia is a slower-progressing type of altered mental status, often caused by conditions within the brain like Alzheimer’s disease. Vascular problems, which may be caused by diabetes, high blood pressure, high cholesterol, and stroke, may also cause dementia. Other causes may include: Medications Pressure on the brain Thyroid hormone imbalance Vitamin deficiency Psychosis. The term "psychosis” is used when people lose touch with reality. Psychosis usually involves hallucinations in which a person sees, hears, or otherwise senses something that is not there. Alternatively, it may cause delusions: The affected person has strong beliefs that are at odds with reality. Some people experience both. Psychosis can be caused by an underlying mental health condition. Psychosis may be caused by mental health conditions such as trauma, stress, severe depression, bipolar disorder, and schizophrenia. Some medical providers also consider changes in consciousness, such as a coma or stupor, to be types of altered mental status. What Causes Altered Mental Status? There are many, many things that can result in someone experiencing an AMS medical condition. Different types of altered mental status may have different causes. For rapid-onset altered mental statuses, such as in psychosis or delirium, causes may include: Central nervous system problems. The central nervous system is made up of the nerves in the brain and spinal cord. Issues with the central nervous system that may lead to psychosis or delirium include: Brain hemorrhage. A brain hemorrhage means bleeding of the brain. Many things can cause brain bleeding including bleeding disorders, clots, head trauma, complications in a pregnancy, and overuse of alcohol or recreational drugs. Brain tumor. A brain tumor is a growth of abnormal cells in the brain. There are many types of brain tumors. Some are cancerous, but not all. Hepatic encephalopathy. Hepatic encephalopathy is a nervous system condition caused by liver disease. If your liver doesn’t work properly, toxins build up within your blood and can make their way to your brain. Obstructive hydrocephalus. Obstructive hydrocephalus is a condition in which a blockage causes a buildup of cerebrospinal fluid, resulting in increased pressure on the brain. Seizure. A seizure is caused by a sudden, uncontrolled electrical disturbance within your brain. There are many types of seizures with many different causes. Stroke. A stroke occurs when blood supply and nutrients to the brain are cut off, either by a clot or burst blood vessel. There are a few different types of strokes, and these strokes can cause a variety of symptoms and effects. Drug overdose or withdrawal. Drug overdoses happen when someone takes more of a medicine or drug than their body can handle. Withdrawal occurs when someone who is physically dependent on a medication or drug stops taking the drug or cuts back. Either may lead to an altered mental state. Infections. Infections happen when germs invade and spread throughout the body. Many types of infections (like meningitis, pneumonia, and even urinary tract infections) can lead to altered mental statuses. Metabolic disorders. Metabolic disorders disrupt your body’s metabolic process, the process of breaking down food for energy. These may include: Dehydration. Dehydration happens when you don’t have enough fluids, like water, for your body to work properly. Hypoglycemia. Hypoglycemia is also called low blood sugar. Common causes include improper diet and too much insulin, a hormone your body needs to balance blood sugar. Hyponatremia. Hyponatremia is a condition in which your body is low on sodium. Hypothermia. When you’re hypothermic, your body temperature drops too low to sustain normal functions. Hypothyroidism. Hypothyroidism is the result of an underactive thyroid. Hypoxemia. Hypoxemia occurs when there is not enough oxygen in your blood.