Delirium in older adults

• Published in: Geriatrics, Gerontology and Aging (Online) Vol. 15; pp. 1 - 12
• Main Authors: Garcez, Flavia Barreto, Avelino-Silva, Thiago Junqueira, Castro, Roberta Esteves Vieira de, Inouye, Sharon K.
• Format: Journal Article
• Language: English
• Published: Brazilian Society of Geriatrics and Gerontology 01-10-2021
• Subjects: aged; delirium; diagnosis
• ISSN: 2447-2123; 2447-2123
• DOI: 10.53886/gga.e0210032

This narrative review provides a broad examination of the most current concepts on the etiopathogenesis, diagnosis, prevention, and treatment of delirium, an acute neuropsychiatric syndrome characterized by fluctuating changes in cognition and consciousness. With the interaction of underlying vulnerability and severity of acute insults, delirium can occur at any age but is particularly frequent in hospitalized older adults. Delirium is also associated with numerous adverse outcomes, including functional impairment, cognitive decline, increased healthcare costs, and death. Its diagnosis is based on clinical and cognitive assessments, preferably following systematized detection instruments, such as the Confusion Assessment Method (CAM). Delirium and its consequences are most effectively fought using multicomponent preventive interventions, like those proposed by the Hospital Elder Life Program (HELP). When prevention fails, delirium management is primarily based on the identification and reversal of precipitating factors and the non-pharmacological control of delirium symptoms. Pharmacological interventions in delirium should be restricted to cases of dangerous agitation or severe psychotic symptoms.