Refining Delirium: A Transtheoretical Model of Delirium Disorder with Preliminary Neurophysiologic Subtypes

Area of Science:

• Neuroscience
• Gerontology
• Psychiatry

Background:

• Delirium signifies neurophysiologic disruption and predicts poor outcomes.
• Current evidence for delirium prevention and management is limited, with no approved medications.
• A singular biological model has hindered progress in delirium research.

Purpose of the Study:

• To propose a transtheoretical model of "delirium disorder" to refine understanding and treatment.
• To differentiate delirium disorder from its phenotype and identify neurophysiologic targets.
• To explore the interplay between procognitive factors and delirium pathology.

Main Methods:

• Conceptual model development: transtheoretical approach.
• Integration of precipitants, neurophysiology, delirium phenotype, and psychiatric symptoms.
• Exploration of relationships with procognitive factors and neuropathologic sequelae.

Main Results:

• A novel "delirium disorder" model is presented, comprising interactive elements.
• The model distinguishes core delirium features from associated psychiatric symptoms.
• Preliminary typology of specific neurophysiologic disturbances is outlined.

Conclusions:

• The proposed model offers novel insights into delirium neurophysiology and treatment targets.
• It differentiates delirium disorder from its phenotype and clarifies symptom associations.
• This framework advances neuroscience's approach to understanding and treating delirium.