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Delirium in older patients associated with greater risk of death, dementia and institutionalization

A review and analysis of previous research indicates that delirium in elderly patients is associated with an increased risk of death, dementia, and institutionalization, independent of age, co-existing illnesses or illness ...

Medicine & Health - Diseases, Conditions, Syndromes

Jul 27, 2010

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Study finds decrease in postoperative delirium in elderly patients

A recent study, published in the January issue of Mayo Clinic Proceedings, demonstrates that in elderly patients undergoing hip fracture repair under spinal anesthesia with propofol sedation, the prevalence of delirium can be ...

Medicine & Health - Other

Jan 19, 2010

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Study: delirium presentation predicts mortality

The way certain patients present in the post-acute hospital setting with delirium, a common, preventable but life-threatening acute confusional state, predicts mortality, according to a study conducted by the Institute for ...

Medicine & Health - Psychology & Psychiatry

Jul 06, 2009

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Delirium may cause rapid cognitive decline in Alzheimer's disease

Alzheimer's disease patients who develop delirium, a sudden state of severe confusion and disorientation, are significantly more likely to experience rapid cognitive decline than Alzheimer's patients who didn't experience ...

Medicine & Health - Neuroscience

May 04, 2009

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Delirium

Delirium or acute confusional state is a common and severe neuropsychiatric syndrome with core features of acute onset and fluctuating course, attentional deficits and generalized severe disorganization of behavior. It typically involves other cognitive deficits, changes in arousal (hyperactive, hypoactive, or mixed), perceptual deficits, altered sleep-wake cycle, and psychotic features such as hallucinations and delusions. It is often caused by a disease process outside the brain, such as infection (urinary tract infection, pneumonia) or drug effects, particularly anticholinergics or other CNS depressants (benzodiazepines and opioids). Although hallucinations and delusions are sometimes present, these are not required for the diagnosis, and the symptoms of delirium are clinically distinct from those induced by psychosis or hallucinogens (with the exception of deliriants.)

Delirium itself is not a disease, but rather a clinical syndrome (a set of symptoms), which result from an underlying disease or new problem with mentation. Like its components (inability to focus attention, mental confusion and various impairments in awareness and temporal and spatial orientation), delirium is simply the common symptomatic manifestation of early brain or mental dysfunction (for any reason). Without careful assessment, delirium can easily be confused with a number of psychiatric disorders because many of the signs and symptoms are conditions present in dementia, depression, and psychosis.

Treatment of delirium requires treatment of the underlying causes. In some cases, temporary or palliative or symptomatic treatments are used to comfort patients or to allow better patient management (for example, a patient who, without understanding, is trying to pull out a ventilation tube that is required for survival). Delirium is probably the single most common acute disorder affecting adults in general hospitals. It affects 10-20% of all hospitalized adults, and 30-40% of elderly hospitalized patients and up to 80% of ICU patients.

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