What is Delirium?

Delirium is a medical condition that causes a temporary problem with mental function. In elderly people, delirium is often the presenting symptom of another underlying illness.    

  • Delirium is a syndrome with multiple causes
  • It often begins quite suddenly
  • The symptoms tend to come and go, and often increase at night
  • Delirium is a medical emergency and early diagnoses and treatment offer the best chance of recovery
  • Delirium is NOT a mental illness, nor is it the same as dementia

 

What are some common symptoms of delirium in elderly people?

  • Confused or muddled thinking and unusual behaviours
  • Emotional upset: anxiety is common
  • Suspicion of others
  • Increased restlessness and irritability
  • Disorientation: unaware of time and place
  • Reduced ability to concentrate and focus attention
  • Delusions or hallucinations

A person with delirium may or may not display all of these behaviours.  Symptoms tend to come and go and are often more prominent at night.

 

What are some common causes of delirium in elderly people? 

  • Infections (e.g., urinary tract or lung infection)
  • Severe illness (e.g., dehydration or severe diabetes)
  • Chronic health problems such as heart failure
  • Post-operational issues: delirium often occurs in people who have undergone neurosurgery, cardiovascular surgery and orthopedic surgery
  • Taking several medications or the harmful effects of certain medications
  • Discontinuing certain drugs or alcohol

In a person who is more vulnerable due to issues like dementia or a previous stroke, a very mild and seemingly insignificant change in their health such as a change in medication, constipation  or a mild infection  can lead to delirium.

 

What are some risk factors for delirium? 

  • Age - especially for those over 80 years
  • Impaired vision or hearing
  • Difficulty completing activities of daily living, such as eating and grooming
  • Taking several medications, or the harmful effects of certain medications
  • Surgery: after an operation, especially if anesthesia was given
  • Illness
  • People with a mild memory impairment or dementia are more likely to experience delirium

 

Treatment and Recovery

Doctors and nurses will try to find the underlying cause(s) delirium by doing a careful assessment including a number of tests. However, sometimes a cause is not found despite reasonable investigation. When the cause(s) is identified, the best treatment can be started.

During recovery stages, patients will often be less confused and disorientated in their own home.  Recovery may take days to months and unfortunately, not everyone with delirium recovers or returns to their usual state.