[Delirium: a marker of health status in the geriatric patient]

Delirium is defined as a syndrome characterized by an acute and fluctuating decline in higher cognitive functions. The impact of this syndrome is often underestimated in the geriatric population both from the diagnostic and prognostic points of view. Many clinicians are unaware of the scale of the impact on outcomes of delirium. This review presents evidence that supports the view that delirium is independently associated with a worse overall outcome, assessed in terms of greater functional and cognitive deterioration, intrahospital complications, and a higher risk of mortality. Likewise, the impact of delirium on the health system (increases in hospital stay, referrals and costs) is discussed. Therefore, we propose that delirium be considered as a marker of health status, which would allow assessment of this syndrome to be broadened to include two fundamental considerations: firstly, that persons with delirium belong to a group with a higher risk of adverse events and secondly, that delirium is a marker of health status, which would allow the quality of health services that manage elderly patients to be evaluated, given that delirium is partly preventable and its management is multidisciplinary and complex.