Delirium in elderly people - 2014 Lancet review

Delirium is an acute disorder of attention and cognition in elderly people (ie, those aged 65 years or older). It is common, serious, costly, under-recognised, and often fatal.

A formal cognitive assessment and history of acute onset of symptoms are necessary for diagnosis.

In view of the complex multifactorial causes of delirium, multicomponent non-pharmacological risk factor approaches are the most effective strategy for prevention.

No convincing evidence shows that pharmacological prevention or treatment is effective.

Drug reduction for sedation and analgesia and non-pharmacological approaches are recommended.

Delirium offers opportunities to elucidate brain pathophysiology — it serves both as a marker of brain vulnerability with decreased reserve and as a potential mechanism for permanent cognitive damage.


Delirium in elderly people - The Lancet
Image source: Hippocampus, from Wikipedia, public domain.

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