[How I treat... Delirium in the aged]

Delirium is an acute psycho-organic disorder, most of the time reversible, that happens in various situations (acute disease, drugs ... ). It can also result from an acute or long term stress when the patient is already in an unstable homeostatic balance. Delirium is common in the geriatric population and can have serious consequences in terms of morbidity and mortality. Unfortunately, it is often not well known by hospital doctors. It is the consequence of predisposing factors (age, polypharmacy, multiple illnesses, neurodegenerative diseases, ... ) and precipitating factors (inadequate medications, dehydration, infections, ...). Diagnosis of delirium is simple with the Confusion Assessment Method (CAM). Rapid diagnosis and management are mandatory to limit functional decline. In people at risk, simple non-drug interventions can prevent the occurrence of delirium. Psychotropic drugs should be used with caution. The prevention of delirium is important and a standardized geriatric assessment to identify old patients at risk should be performed before any surgery or heavy treatment.