[Delirium in the elderly; article for education and training purposes]

Area of Science:

• Geriatrics
• Neurology
• Psychiatry

Background:

• Delirium presents as an acute alteration in consciousness, marked by fluctuating attention, cognition, and perception.
• It can be precipitated by underlying medical conditions, or by the use or cessation of certain drugs.
• Key risk factors include advanced age and pre-existing cognitive impairment.

Purpose of the Study:

• To summarize the understanding of delirium, including its causes, risk factors, and consequences.
• To emphasize the importance of non-pharmacological interventions in delirium management.
• To clarify the limited and specific role of antipsychotics in treating delirium.

Main Methods:

• Review of existing literature on delirium pathophysiology, risk factors, and treatment modalities.
• Analysis of the impact of delirium on patients, healthcare systems, and caregivers.
• Evaluation of the evidence supporting non-pharmacological and pharmacological interventions.

Main Results:

• Delirium is associated with significant complications, increased hospital stays, and elevated healthcare costs.
• Non-pharmacological strategies demonstrate effectiveness in both preventing and treating delirium.
• Antipsychotic medication use should be exceptional, reserved for situations involving patient or other endangerment, or severe symptomatic distress.

Conclusions:

• Effective delirium management relies heavily on non-pharmacological approaches.
• Antipsychotics are not a first-line treatment and should be used judiciously.
• Understanding risk factors and implementing preventive measures are crucial for improving patient outcomes and reducing healthcare burden.