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Delirium in the hospitalized elderly
1Department of Medicine, Milton S. Hershey Medical Center, Hershey, PA 17033.
Cleveland Clinic Journal of Medicine
|July 1, 1994
Summary
Delirium affects one-third of elderly hospitalized patients, increasing mortality and cognitive decline risk. Early diagnosis and treatment are crucial for better outcomes.
Area of Science:
- Geriatric Medicine
- Neurology
- Critical Care Medicine
Background:
- Delirium affects up to one-third of elderly hospitalized patients.
- Most patients do not fully recover from delirium.
- Delirium is associated with increased mortality and future cognitive decline.
Purpose of the Study:
- To review the clinical features of delirium in elderly hospitalized patients.
- To discuss the etiology, diagnosis, and management of delirium in this population.
Main Methods:
- Literature review of clinical features, etiology, diagnosis, and management of delirium.
- Emphasis on clinical presentation and diagnostic challenges.
- Discussion of treatment strategies and preventative measures.
Main Results:
- Delirium presents with diverse clinical features, necessitating suspicion in elderly patients with altered mental status.
- Common causes include drug intoxication, withdrawal, intracranial disease, and systemic diseases.
- Anticholinergic drugs are frequent culprits, but all medications should be reviewed.
Conclusions:
- Physicians should suspect delirium in elderly patients with changes in mental status, personality, or behavior.
- Bedside screening tools can aid in differentiating delirium from dementia and psychosis.
- Systematic diagnosis and prompt treatment, including addressing causative factors and judicious medication use, can be life-saving.