BMJ 2007;334:842-846 (21 April), doi:10.1136/bmj.39169.706574.AD
Clinical Review
Clinical review
Delirium in older people
John Young, professor1,
Sharon K Inouye, professor2
1 Academic Unit of Elderly Care and Rehabilitation, University of Leeds and Bradford Teaching Hospitals NHS Foundation Trust ,
2 Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, and Aging Brain Center, Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA
Correspondence to: Professor J Young, Academic Unit of Elderly Care and Rehabilitation, St Luke's Hospital, Bradford BD5 0NA John.young@bradfordhospitals.nhs.uk
| The first 150 words of the full text of this article appear below. |
Few ill health situations are more degrading to people of any age than loss of reasoning, faculties, and personhood. These are the unpleasant consequences of deliriuma common condition affecting ill older people, particularly those with some degree of dementia. It is characterised by recent onset of fluctuating inattention and confusion, linked to one or more triggering factors.
SUMMARY POINTS
- Delirium is a common presentation of acute illness in older people
- The development of delirium is associated with adverse outcomes
- Delirium is characterised by recent onset of fluctuating inattention and drowsiness linked to triggering factors
- Routine cognitive assessment in unwell older people would improve detection rates
- Good research evidence exists that, with better systems of routine care, delirium could be prevented in at least a third of patients
| |
Delirium is a major burden to healthcare services and has been largely ignored by health service planners and practitioners.1 Moreover, . . . [Full text of this article]
Sources and selection criteria
How common is delirium?
What are the consequences of delirium?
What are the clinical features of delirium?
Box 1 Criteria for delirium, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM IV)8Box 2 Hyperactive deliriumScenarioFeaturesBox 3 Hypoactive deliriumScenarioFeaturesHow is delirium diagnosed?
Box 4 Confusion assessment method*13 141 Acute onset and fluctuating course2 Inattention3 Disorganised thinking4 Altered level of consciousnessThe overlap between delirium and dementia
What are the causes of delirium?
Box 5 Common risk factors and precipitants for deliriumRisk factorsPrecipitants (more than one may be present)Drugs and deliriumCan delirium be prevented?
How can delirium be managed?
Conclusions
ADDITIONAL EDUCATIONAL RESOURCESResources for patientsResources for healthcare professionals

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