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Delirium in elderly people: a review
1Research and Education Unit on Aging, UNIFAI/ICBAS, University of Porto Porto, Portugal.
Frontiers in Neurology
|June 23, 2012
Summary
Delirium, an acute confusional state in elderly people, is often under-recognized. Early identification and management are crucial to reduce adverse outcomes like cognitive decline and mortality.
Area of Science:
- Gerontology
- Neurology
- Psychiatry
Background:
- Delirium is an acute confusional state in the elderly, characterized by rapid onset, fluctuating consciousness, and cognitive disturbances.
- Its pathophysiology involves neurotransmission disruption, inflammation, and stress responses, often triggered by multiple risk factors including dementia and acute illness.
- Delirium is frequently under-recognized and misdiagnosed due to its fluctuating nature and overlap with dementia.
Purpose of the Study:
- To review the diagnosis, pathophysiology, etiology, prevention, and management of delirium in the elderly.
- To emphasize the importance of early identification and timely intervention for delirium.
- To highlight strategies for reducing adverse outcomes associated with delirium.
Main Methods:
- Review of existing literature on delirium in elderly populations.
- Analysis of diagnostic criteria, including clinical observation, cognitive assessment, and physical/neurological examination.
- Discussion of pathophysiological mechanisms, risk factors, and clinical presentations (hyperactive, hypoactive, mixed).
Main Results:
- Delirium diagnosis relies on clinical assessment, cognitive tests, and examination, presenting in various psychomotor forms.
- Under-recognition stems from fluctuating symptoms, overlap with dementia, and lack of routine cognitive screening.
- Adverse outcomes include prolonged hospital stays, functional decline, institutionalization, and increased mortality.
Conclusions:
- Early identification and prompt management of delirium in the elderly are essential.
- Management strategies include addressing underlying causes, optimizing the care environment, and enhancing healthcare professional education.
- Effective interventions can significantly decrease the adverse outcomes associated with delirium.
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