BMJ  2007;334:968 (12 May), doi:10.1136/bmj.39199.484942.3A

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Delirium in older people

Approach is now screening, prevention, and recognition

The first 150 words of the full text of this article appear below.

The approach to delirium has shifted from ad hoc treatment to systematic screening and prevention.1 Management may be improved with primary prevention, early detection, and prompt management.

Preoperative cognitive impairment, as measured by the mini mental state examination or the clock drawing test, is an important predictor for postoperative delirium. Most elderly patients developing postoperative delirium after hip surgery already have early prodromal symptoms. Low dose prophylactic haloperidol can reduce the incidence.2 Niam et al showed that methods proved to prevent delirium can be useful in routine clinical practice.3

In a large retrospective study only 4% of patients had a recorded diagnosis of delirium, yet an episode may occur in up to 56% of hospitalised older people.4 The poor understanding of delirium by staff stems from a historically low educational emphasis in medical and nursing schools. Increasing doctors' and nurses' awareness can be achieved through a brief and inexpensive educational . . . [Full text of this article]

Mehraj Shah, staff grade psychiatrist, Farida Jan, senior house officer, Akeem Sule, consultant psychiatrist

Bedfordshire and Luton Mental Health and Social Care Partnership NHS Trust, Luton LU1 2PJ

Mehraj.shah@blpt.nhs.uk


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Relevant Article

Delirium in older people
John Young and Sharon K Inouye
BMJ 2007 334: 842-846. [Extract] [Full Text] [PDF]

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  • Davis, D., MacLullich, A. (2009). Understanding barriers to delirium care: a multicentre survey of knowledge and attitudes amongst UK junior doctors. Age Ageing 38: 559-563 [Abstract] [Full text]  
  • Koster, S., Hensens, A. G., van der Palen, J. (2009). The long-term cognitive and functional outcomes of postoperative delirium after cardiac surgery.. Ann. Thorac. Surg. 87: 1469-1474 [Abstract] [Full text]  
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