The active management of delirium: improving detection and
                        treatment

Meagher, David; Leonard, Maeve

doi:10.1192/apt.bp.107.003723

Cited by 36 publications

(24 citation statements)

References 46 publications

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“…Treatment response to antipsychotics is superior to use in dementia18 where use for dementia agitation and psychosis is associated with increased mortality 19. These concerns highlight the need to carefully evaluate features, including phenomenological profile, in order to better distinguish these disorders20 with revised diagnostic criteria in DSM-V and International Classification of Disease (ICD)-11 more accurately reflecting those differences.…”

Section: Discussionmentioning

confidence: 99%

A comparison of neuropsychiatric and cognitive profiles in delirium, dementia, comorbid delirium-dementia and cognitively intact controls

Meagher

Leonard

Donnelly³

et al. 2010

Journal of Neurology, Neurosurgery & Psychiatry

102

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Purpose: Delirium and dementia have overlapping features that complicate differential diagnosis. Delirium symptoms overshadow dementia symptoms when they co-occur, but delirium phenomenology in comorbid cases has not been compared to both conditions alone. Methods:Consecutive adults with DSM-IV delirium, dementia, comorbid deliriumdementia, and cognitively intact controls were assessed using the Revised Delirium Rating Scale (DRS-R98) and Cognitive Test for Delirium (CTD).Results : Delirium and comorbid delirium-dementia groups had comparable DRS-R98 and CTD total scores which were greater than in dementia or control groups.On the DRS-R98, multiple non-cognitive symptoms, inattention and disorientation were more severe in delirium groups compared with dementia-alone. Patients with dementia differed from both delirium groups on the CTD test of attention. Spatial span backwards was significantly lower in all patients with cognitive impairment (delirium, comorbid delirium-dementia, dementia alone) compared to controls, whereas spatial span forwards distinguished delirium groups from dementia. Conclusions:Delirium phenomenology is similar with or without comorbid dementia. A wide range of neuropsychiatric symptoms distinguish delirium from dementia. Spatial span forward is disproportionately diminished in delirium , suggesting usefulness as a differentiating screening test. Declaration of interest:The authors wish to acknowledge the support and cooperation of nursing and medical staff at Milford Hospice Palliative care centre.

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Section: Discussionmentioning

confidence: 99%

A comparison of neuropsychiatric and cognitive profiles in delirium, dementia, comorbid delirium-dementia and cognitively intact controls

Meagher

Leonard

Donnelly³

et al. 2010

Journal of Neurology, Neurosurgery & Psychiatry

102

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“…15 22 Several evidence based guidelines on the management of delirium exist, and all broadly recommend the following approaches. [13][14][15][16][17][18][19][20][21][22][23][24] Clinicians may consider off ering:…”

Section: How Is Hypoactive Delirium Managed?mentioning

confidence: 99%

Hypoactive delirium

Hosker¹,

Ward

2017

BMJ

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“…The pharmacological treatment should be continued until symptoms fully resolve 49. There is a consensus that medication should be discontinued once the patient has been free of symptoms for 1 week,50 though it is sensible to titrate the dose downwards, monitoring for the re-emergence of symptoms, re-increasing or restarting the medication if necessary.…”

Section: Managementmentioning

confidence: 99%

Delirium in the elderly: a clinical review

Saxena

Lawley

2009

Postgraduate Medical Journal

151

169

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Delirium is a common condition in the elderly, affecting up to 30% of all older patients admitted to hospital. There is a particularly high risk of delirium in surgical inpatients, especially following operations for hip fracture or vascular surgery, but also for patients in the intensive care unit. Patients with delirium have higher morbidity and mortality rates, higher re-admission rates, and a greater risk of long term institutionalisation care, thereby having a significant impact on both health and social care expenditure. Delirium frequently goes unrecognised by clinicians and is often inadequately managed. Recent evidence suggests that a better understanding and knowledge of delirium among health care professionals can lead to early detection, the reduction of modifiable risk factors, and better management of the condition in the acute phase. Many cases of delirium are potentially preventable, and primary and secondary care services should be taking active steps in order to do prevent this condition.

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The active management of delirium: improving detection and treatment

Cited by 36 publications

References 46 publications

A comparison of neuropsychiatric and cognitive profiles in delirium, dementia, comorbid delirium-dementia and cognitively intact controls

A comparison of neuropsychiatric and cognitive profiles in delirium, dementia, comorbid delirium-dementia and cognitively intact controls

Hypoactive delirium

Delirium in the elderly: a clinical review

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