Delirium in the elderly: Current problems with increasing geriatric age

Abstract

Delirium is an acute disorder of attention and cognition seen relatively commonly in people aged 65 yr or older. The prevalence is estimated to be between 11 and 42 per cent for elderly patients on medical wards. The prevalence is also high in nursing homes and long term care (LTC) facilities. The consequences of delirium could be significant such as an increase in mortality in the hospital, long-term cognitive decline, loss of autonomy and increased risk to be institutionalized. Despite being a common condition, it remains under-recognised, poorly understood and not adequately managed. Advanced age and dementia are the most important risk factors. Pain, dehydration, infections, stroke and metabolic disturbances, and surgery are the most common triggering factors. Delirium is preventable in a large proportion of cases and therefore, it is also important from a public health perspective for interventions to reduce further complications and the substantial costs associated with these. Since the aetiology is, in most cases, multfactorial, it is important to consider a multi-component approach to management, both pharmacological and non-pharmacological. Detection and treatment of triggering causes must have high priority in case of delirium. The aim of this review is to highlight the importance of delirium in the elderly population, given the increasing numbers of ageing people as well as increasing geriatric age.

<p>Evaluation of pharmacist interventions and commonly used medications in the geriatric ward of a teaching hospital in Turkey: a retrospective study</p>

“…Delirium incidences increase in patients over 65 years, and in selected patients, haloperidol or second-generation antipsychotics can be used to reduce agitation and hyperactivity. 35,36 In this study, quetiapine was ranked first among medications with the highest possible DRP count among nervous system drugs and was also found to almost always (97.5%) cause possible drug interactions when prescribed. As polypharmacy is a factor known to increase mortality in patients with delirium, 36 pharmacists should control quetiapine orders for interactions and other DRPs.…”

Delirium en el adulto mayor

“…El delirium se desencadena cuando el paciente está expuesto a múltiples factores precipitantes, tales como: infección, medicamentos, dolor y deshidratación (9). Además, se conocen otros factores relevantes como lo son las infecciones del tracto urinario, neumonía, fractura de hueso, anemia, desordenes hidroelectrolíticos e insuficiencia hepática (10).…”

Management of Very Old Patients in Intensive Care Units

“…Delirium is an acute disorder of attention and cognition in elderly people that is common, serious, costly, under-recognized, and often fatal [ 55 , 56 ]. Nearly 30% of older patients (aged >65 years) experience delirium at some point during hospitalization, and 40% of older patients admitted to the ICU have delirium [ 57 ].…”