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 older adults?
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 older adults?
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) of 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.
