What is the prevalence of delirium in patients aged >85 years?
14%
What is the prevalence of delirium in older hospitalized patients?
10-40%
What is a common cause of delayed discharge in delirium patients?
Delirium
What are some precipitating insults that can cause delirium?
Drugs, primary neurological conditions, acute illness, surgery, metabolic issues, pain, sleep deprivation, drug withdrawal
What are some risk factors for delirium?
Elderly, dementia, blindness/deafness, history of delirium, surgery, comorbid conditions, decreased oral intake, frailty
What are some clinical presentations of delirium?
Inability to direct, sustain, and shift attention, impairment of cognition with disorientation, impairment of recent memory, disturbed sleep, psychomotor agitation, perceptual distortion and deception, speech disturbances, disordered thought, rapid onset with fluctuations in severity over minutes and hours, paranoid delusions, nausea and vomiting, autonomic dysfunction
What are some differential diagnoses for delirium?
Mood disorder, psychosis, dementia
How is delirium diagnosed?
Mainly clinical, identifying risk factors, ruling out other potential causes, identifying precipitating causes and exacerbating factors
What are some management strategies for delirium?
Treating precipitating causes and exacerbating factors, stabilizing the patient, providing environmental and supportive measures, avoiding sedation unless severely agitated or necessary to minimize risk to the patient, using single medications at low doses and titrating to effects, reassessing regularly, considering benzodiazepines as first line for alcohol withdrawal
What is delirium?
An acute, fluctuating change in mental status, with inattention, disorganized thinking, and altered levels of consciousness.