BMJ  2007;334:968 (12 May), doi:10.1136/bmj.39205.543843.BE

Letters

Delirium in older people

Delirium should be included in guidelines and curriculums

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

One critical factor in the underdiagnosis and undertreatment of delirium in the United Kingdom is likely to be its unsatisfactory coverage in core guidelines and curriculums.

Delirium is not mentioned in the draft guideline on acutely ill patients in hospital from the National Institute for Health and Clinical Excellence (NICE).¹ However, it occurs in 11-42% of medical inpatients and missing the diagnosis can have serious consequences.²

Delirium is also absent from the Joint Committee of Higher Medical Training curriculums for general internal medicine and acute medicine.^{3 4} "Acute confusional states" are mentioned in the latter, but only in the context of minimising distress. In the curriculum from the Royal Colleges of Physicians the sole reference to delirium is in the section on aggressive/disturbed behaviour,⁵ although only a few patients with delirium display aggression. "Acute confusion" appears in the top 20 presentations and the section on medicine in the elderly but with . . . [Full text of this article]

¹ Queen's Medical Research Institute, Edinburgh EH16 4TJ, ² Royal Victoria Hospital, Edinburgh EH4 2DN, ³ Queen's University of Belfast, Belfast BT9 7BL

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Delirium in older people

John Young and Sharon K Inouye
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