Recognizing the Clinical Features of Delirium can Save the Lives of the Hospitalized Elderly
Nariman Malik, BSc
Confusion in the elderly is a common problem. Its onset may be acute or chronic and progressive in nature. Confusion may be a symptom of delirium or dementia but it may also be associated with psychoses and affective disorders, in particular major depression.1 This article focuses on delirium, one of the most common and frequently unrecognized causes of confusion in the elderly.
Delirium is a syndrome of disturbed consciousness, attention and cognition or perception, which develops acutely, fluctuates during the course of the day, and is a direct physiologic consequence of a general medical condition.2-4 Delirious patients may also have psychomotor and emotional disturbances. In most cases, delirium is reversible upon treatment of the underlying medical condition.1 Currently, a great deal of attention is being focused on this condition because of the huge impact it has on patients and their families, as well as on patient care costs. Delirium is a phenomenon that is common in hospitalized patients, and is associated with high morbidity and mortality rates, and significantly extended lengths of hospital stay.5
The incidence of delirium increases progressively after the fourth decade of life.