Delirium in elderly people: A review

• Type: Article in International Scientific Journal
• Date: 2012

Authors

Sónia Martins (Author) FMUP; Lia Fernandes (Author) FMUP

Journal

Title: Frontiers in Neurology

Vol. JUN

Pages: 1-12

ISSN: 1664-2295

Publisher: Frontiers Media

Indexing

Scopus - 104 Citations

Pubmed / Medline

Scientific classification

FOS: Medical and Health sciences > Other medical sciences

Other information

Authenticus ID: P-008-5ZN

DOI: 10.3389/fneur.2012.00101

Abstract (EN): The present review aims to highlight this intricate syndrome, regarding diagnosis, patho-physiology, etiology, prevention, and management in elderly people. The diagnosis of delirium is based on clinical observations, cognitive assessment, physical, and neurological examination. Clinically, delirium occurs in hyperactive, hypoactive, or mixed forms, based on psychomotor behavior. As an acute confusional state, it is characterized by a rapid onset of symptoms, fluctuating course and an altered level of consciousness, global disturbance of cognition or perceptual abnormalities, and evidence of a physical cause. Although pathophysiological mechanisms of delirium remain unclear, current evidence suggests that disruption of neurotransmission, inflammation, or acute stress responses might all contribute to the development of this ailment. It usually occurs as a result of a complex interactionof multiple risk factors, such as cognitive impairment/dementia and current medical or surgical disorder. Despite all of the above, delirium is frequently under-recognized and often misdiagnosed by health professionals. In particular, this happens due to its fluctuating nature, its overlap with dementia and the scarcity of routine formal cognitive assessment in general hospitals. It is also associated with multiple adverse outcomes that have been well documented, such as increased hospital stay, function/cognitive decline, institutionalization and mortality. In this context, the early identification of delirium is essential. Timely and optimal management of people with delirium should be performed with identification of any possible underlying causes, dealing with a suitable care environment and improving education of health professionals. All these can be important factors, which contribute to a decrease in adverse outcomes associated with delirium. © 2012 Martins and Fernandes.

Language: English

Type (Professor's evaluation): Scientific