Delirium in hospitalized older patients

Abstract

Many older patients who were lucid previously to hospital admission will soon develop a mental state of confusion or delirium, and this is common in the first night at the ward.

The author discusses the severa! designations of the syndrome, its presentation and symptoms. Being the physiopathology poorly studied and understood, the more consensual causalities are outlined: abrupt change of  residence  with consequent  loss of orienting references; vulnerability induced by physical illness, namely by fever, pain and dehydration; iatrogenic mechanisms, invasive procedures and some medicines included.

The treatment of delirium in hospitalized older patients is not yet established. Nevertheless, there are some interesting results of preventing protocols. The benefits obtained in a recent prophylactic intervention, carried on in Yale (USA) are shortly commented.

ln conclusion, the more feasible and useful prevention measures suggested here in are: to minimize the time of hospitalization of the elder; to avoid aggressive procedures; and to restrain the use of psychoactive compounds.