Delirium in Older Persons: Prevention, Evaluation, and Management

Link to article at PubMed

Am Fam Physician. 2023 Sep;108(3):278-287.


Delirium is an acute disturbance in attention, cognition, and awareness that fluctuates over time. Delirium is characterized by three subtypes: hyperactive, hypoactive, and mixed. It occurs in 11% to 25% of older adults in inpatient settings and is associated with a significant financial burden. Older age, multiple comorbidities, recent surgery, and polypharmacy are independent risk factors for delirium. The diagnosis is clinical but can be challenging due to overlapping symptoms with dementia and depression. The Confusion Assessment Method is a screening tool that is 94% to 100% sensitive haloperidol because of their faster onset of action and fewer adverse effects. Patients hospitalized with prolonged delirium have approximately three times the chance of dying in the following year compared with patients with a quick resolution of delirium or no symptoms; therefore, prevention and early detection should be emphasized.


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