Clinical ReviewDelirium in Elderly Patients
Section snippets
Acute Onset
The symptoms of delirium usually develop over hours-to-days, although onset may be abrupt.
Prodromal Phase
When the onset is more gradual, the patient may report mild, transient symptoms, such as fatigue, decreased concentration, irritability, restlessness, anxiety, or depression. There may be mild cognitive impairment, perceptual disturbances, or hypersensitivity to light and sound. Commonly, there is daytime somnolence or a sleep disturbance. The disturbance may be limited to this mild prodromal phase or
CONCLUSION
Delirium is a frequent and serious mental disorder in elderly patients. It is often not diagnosed, even though there are potential strategies (e.g., screening by nurses, risk-factor assessment) and instruments that can improve detection and diagnosis. Although there has been limited progress in understanding the etiology, pathogenesis, assessment, and specific treatment of delirium, systematic detection and treatment programs appear to be beneficial for elderly surgical patients, as are
References (131)
- et al.
Assessment of coma and impaired consciousness
Lancet
(1974) - et al.
“Mini-Mental State:” a practical method for grading the cognitive state of patients for the clinician
J Psychiatr Res
(1975) - et al.
Delirium and other cognitive impairment in older adults in an emergency department
Ann Emerg Med
(1995) - et al.
Unrecognized delirium in ED geriatric patients
Am J Emerg Med
(1995) - et al.
The association of serum anticholinergic activity with delirium in elderly medical patients
Am J Geriatr Psychiatry
(1998) - et al.
Association of postoperative delirium with raised serum levels of anticholinergic drugs
Lancet
(1981) - et al.
Electroencephalographic abnormalities in interferon encephalopathy: a preliminary report
Mayo Clin Proc
(1984) - et al.
Is postoperative delirium related to reduced plasma tryptophan?
Lancet
(1991) - et al.
Beta-endorphin, cortisol, and postoperative delirium: a preliminary report
Psychoneuroendocrinology
(1985) - et al.
The Memorial Delirium Assessment Scale
J Pain Symptom Manage
(1997)