Delirium in elderly people: an update

  title={Delirium in elderly people: an update},
  author={Albert F. G. Leentjens and Rose C. van der Mast},
  journal={Current Opinion in Psychiatry},
Purpose of review To review recent studies on epidemiology, diagnosis, pathophysiology, treatment and prevention of delirium in elderly people. Recent findings There is no evidence that the clinical picture of delirium in elderly people differs from that in younger patients, although it may run a more chronic course. Diagnosing delirium in demented patients, however, may be difficult due to overlap in symptoms of delirium and dementia. Systematic use of screening and diagnostic instruments may… 
Delirium and Acute Confusional State
Because delirium developed by interactions among the multiple factors, organized multifactorial approach to the prevention and management of theDelirium is highly required and medical staff’s well understanding and continuous awareness about delirio would be most effective diagnostic strategy of the deliria.
The many faces of psychosis in the elderly
There is support for the use of antipsychotic drugs for all types of psychosis in the elderly and while the atypical antipsychotics have a ‘black box warning’ on risk of death in elderly patients with dementia, the typical antippsychotics carry an even higher risk ofdeath and adverse effects.
Delirium and its Treatment
Benzodiazepines are the drugs of choice for delirium that is not controlled with an antipsychotic, and Lorazepam is the benzodiazepine of choice as it has a rapid onset and shorter duration of action, a low risk of accumulation, no major active metabolites and its bioavailability is more predictable when it is administered both orally and intramuscularly.
Anticholinergic drug-induced delirium in an elderly Alzheimer's dementia patient.
Etiological Evaluation of Acute Confusional State in Elderly (≥60 Years) Patients
Uncontrolled hypertension, fever & infection, uncontrolled diabetes, CVD, CKD & electrolytes abnormalities and polypharmacy were found commonly in patients with acute confusional state.
A Study on Etiology of Acute Confusional State in Elderly with Short Term Outcome.
Patients with multiple comorbidities and in whom no definite cause could be found for the acute confusional state had poorer prognosis in terms of higher mortality, and patients without a precipitating cause and multiple co morbidities had significantly higher mortality.
Acute confusional state/delirium: An etiological and prognostic evaluation
Patients with an abnormal work-up (possible precipitating cause) had significantly lower mortality, less duration of hospital stay and less severe disability after 3 months, and age, underlying illness, serum creatinine, abnormal neuroimaging and MBI were identified as a significant prognostic indicator.
Prolonged activation EEG differentiates dementia with and without delirium in frail elderly patients
Objective: Delirium in the elderly results in increased morbidity, mortality and functional decline. Delirium is underdiagnosed, particularly in dementia. To increase diagnostic accuracy, we


Multidisciplinary team interventions for delirium in patients with chronic cognitive impairment.
The available evidence for the effectiveness, if any, of multidisciplinary team interventions in the coordinated care of elderly patients with delirium superimposed on an underlying chronic cognitive impairment in comparison with usual care is assessed.
Delirium in Elderly People Without Severe Predisposing Disorders: Etiology and 1-Year Prognosis After Discharge
Among healthy elderly people, infections and cerebrovascular attacks were the most important etiologic factors for delirium and after discharge to home, 30% of the patients had to be taken into long-term care or had died within 1 year of the delirious state.
Delirium episode as a sign of undetected dementia among community dwelling elderly subjects: a 2 year follow up study
Assessment of the importance of a delirium episode as a symptom of an underlying dementia among community dwelling healthy elderly people in a prospective 2 year follow up study found it to be the first sign of dementia requiring attention from medical and social professionals.
Prevalence and detection of delirium in elderly emergency department patients.
Despite the relatively high prevalence of delirium in elderly ED patients, the sensitivity of a conventional clinical assessment for this condition is low and there is a need to improve the detection ofDelirium by ED physicians.
Delirium in older medical inpatients and subsequent cognitive and functional status: a prospective study.
For older patients with and without dementia, delirium is an independent predictor of sustained poor cognitive and functional status during the year after a medical admission to hospital.
Low incidence of delirium in very old patients after surgery for hip fractures.
It is documented that the incidence of delirium after hip fracture in elderly patients is much lower than was reported in several previous studies, and premorbid cognitive impairment was the most significant predisposing factor for the development ofDelirium.
Development of Delirium: A Prospective Cohort Study in a Community Hospital
A model for new delirium in hospitalized older patients that included process of care and social variables was developed and it was found that approximately one older patient in five developedDelirium after admission to a medical or surgical unit.
Symptoms of delirium among elderly medical inpatients with or without dementia.
Delirium appeared to be phenomenologically similar among patients with and those without dementia, although patients with dementia had more psychomotor agitation at the time of diagnosis and more disorganized thinking and disorientation at the second assessment.
Risk Factors and Incidence of Postoperative Delirium in Elderly Chinese Patients
Few risk factors of postoperative delirium in the older Chinese sample were identified, and the only modifiable risk factor appears to be the use of psychoactive drugs.
Use of medications with anticholinergic effect predicts clinical severity of delirium symptoms in older medical inpatients.
Exposure to ACH medications is independently and specifically associated with a subsequent increase inDelirium symptom severity in elderly medical inpatients with diagnosed delirium.