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Delirium in elderly patients.

Martin G Cole1

  • 1Department of Psychiatry, St. Mary's Hospital and McGill University, Montreal, Quebec Canada. martin.cole@ssss.gouv.qc.ca

The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry
|January 20, 2004
PubMed
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Delirium, a common yet often missed condition in elderly hospital patients, significantly worsens outcomes. Systematic detection and treatment programs are recommended for acute-care hospitals to improve patient care.

Area of Science:

  • Geriatric Medicine
  • Neuroscience
  • Hospital Administration

Background:

  • Delirium is an acute mental disorder affecting consciousness, cognition, and behavior, with significant negative impacts on elderly hospital patients.
  • It is frequently underdiagnosed or misdiagnosed as dementia, despite its association with increased disability, longer hospital stays, and mortality.
  • Prevalence in elderly inpatients can reach up to 50%, often in hyperactive, hypoactive, or mixed forms.

Purpose of the Study:

  • To review the clinical importance, detection challenges, and management strategies for delirium in elderly hospital inpatients.
  • To evaluate the evidence supporting systematic detection, treatment, and prevention programs for delirium.
  • To provide recommendations for the implementation of these programs in acute-care settings.

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Main Methods:

  • Literature review and synthesis of existing evidence on delirium's etiology, pathogenesis, assessment, and treatment.
  • Analysis of the impact of delirium on patient outcomes and healthcare costs.
  • Evaluation of the effectiveness of screening tools, risk-factor assessments, and programmatic interventions.

Main Results:

  • Systematic detection and treatment programs show benefits for elderly surgical patients.
  • Preventive programs are effective for both elderly medical and surgical patients.
  • Despite limited progress in understanding delirium's core mechanisms, evidence supports program implementation.

Conclusions:

  • Systematic detection and preventive programs for delirium are beneficial and should be implemented in acute-care hospitals.
  • Early identification and management are crucial to mitigate the adverse effects of delirium on elderly patients.
  • Further research into delirium's etiology and pathogenesis is needed, but current evidence supports practical interventions.