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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Delirium in the elderly: Current problems with increasing geriatric age.

Deepti Kukreja, Ulf Günther, Julius Popp1

  • 1Department of Psychiatry, Service of Old Age Psychiatry, University Hospital of Lausanne, Switzerland. Site de Cery. 1008 ; Department of Clinical Neurosciences, Leenaards Memory Center, University Hospital of Lausanne, Lausanne, Switzerland. Ch. de Mont-Paisible 16, CH-1011 Lausanne, Switzerland.

The Indian Journal of Medical Research
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Delirium, an acute cognitive disorder in older adults, is common and has serious consequences. Early recognition and multi-component management are crucial for prevention and reducing complications.

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Area of Science:

  • Geriatrics
  • Neurology
  • Public Health

Background:

  • Delirium is a common acute cognitive disorder in individuals aged 65 and older, affecting 11-42% of elderly patients in medical wards.
  • High prevalence is also observed in nursing homes and long-term care (LTC) facilities, with significant consequences including increased mortality and long-term cognitive decline.
  • Despite its frequency, delirium remains under-recognized, poorly understood, and inadequately managed, posing a substantial public health challenge.

Purpose of the Study:

  • To emphasize the critical importance of delirium in the aging population.
  • To highlight the need for increased awareness and improved management strategies for delirium in the elderly.
  • To underscore the public health implications of delirium due to the growing elderly demographic.

Main Methods:

  • This review synthesizes current knowledge on delirium in the elderly.
  • It focuses on prevalence, risk factors, triggering factors, consequences, and management approaches.
  • Emphasis is placed on a multi-component management strategy, including pharmacological and non-pharmacological interventions.

Main Results:

  • Advanced age and pre-existing dementia are primary risk factors for delirium.
  • Common triggers include pain, dehydration, infections, stroke, metabolic disturbances, and surgery.
  • Delirium is preventable in many cases, necessitating public health interventions.

Conclusions:

  • Prompt detection and treatment of underlying causes are paramount in managing delirium.
  • A multifactorial etiology requires a comprehensive, multi-component management approach.
  • Effective delirium management can reduce complications, healthcare costs, and improve patient outcomes in the elderly.