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Delirium in Elderly is Common But Preventable

Neil Osterweil
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco | April 20, 2007
  • Explain to caregivers that delirium is common among elderly patients, with risk factors that include frailty, dementia, hospitalization for infection or dehydration, visual impairment, deafness, renal impairment, malnutrition, and polypharmacy.

BRADFORD, England, April 20 -- Well-meaning physicians may unwittingly induce delirium in older patients when they prescribe medications such as antihistamines or sleep aids.

But by being aware of the factors that can trigger confusion or disorientation in the elderly, clinicians may be able to prevent a significant number of delirium cases.

So found John Young, M.D., of the University of Leeds and Bradford Teaching Hospitals here, and Sharon K. Inouye, M.D., M.P.H., of the Beth Israel Deaconess and Harvard in Boston in a clinical review of published studies in the April 21 issue of BMJ.

Indeed, there are reports in the literature, they wrote, that more than half of all cases of delirium in older patients go unrecognized, lost in the realm between frank dementia and temporary confusion. Yet at least a third of delirium cases are preventable, they added.

The diagnosis of delirium can be challenging, the authors wrote, because clinicians have only their diagnostic skills to guide them.

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