Delirium in Older Patients Should Not be Ignored

A sudden severe confusion and rapid changes in brain that is most often caused by physical or mental illness in older people, "Delirium" is often ignored and untreated.

The researchers from the US and UK including the University of East Anglia (UAE) focus on this disease that is usually temporary and reversible. This disease is triggered by several disorders such as lack of oxygen or other substance.

The details of this study were published in the September issue of the Journal of Hospital Medicine. The study states that acute confusion or delirium is wide spread among older adults in hospitals and nursing homes. It displays a negative impact on the cognition and independence, thereby multiplying the risk of developing dementia and increasing the likelihood of death.

This study was led by Regenstrief Institute and Indiana University. The team reviewed 45 years of research that included 58 studies. They noticed that one in three cases of delirium were preventable and are calling for delirium to be identified and treated early to prevent poor long-term prognosis.

"As a geriatric psychiatrist I have seen that around 50 per cent or people with dementia in hospital develop delirium," said co-author Dr Chris Fox, of Norwich Medical School at the University of East Anglia.

"This is because in addition to having dementia, they have multiple risk factors that can predispose and precipitate delirium -- including serious illnesses and pre-existing cognitive impairment. In addition, hospital staff commonly label the signs as dementia related and do not pick up the delirium."

"We need to develop better mechanisms for diagnosing delirium so that prompt treatment regimes can be initiated."

The authors, led by Dr Babar Khan of the Regenstrief Institute and Indiana University School of Medicine, said that delirium could be prevented by eliminating restraints, treating depression, ensuring that patients have access to glasses and hearing aids, and prescribing classes of antipsychotics that do not negatively affect the aging brain. They also noted the need for a more sensitive screening tool for delirium, especially when administered by a non-expert.

"Delirium is extremely common among older adults in intensive care units and is not uncommon in other hospital units and in nursing homes, but too often it is ignored or accepted as inevitable," said Dr Khan. "Delirium significantly increases risk of developing dementia and triples likelihood of death. It cannot be ignored."

Co-author Dr Malaz Boustani, of the Regenstrief Institute, Indiana University School of Medicine and Wishard Healthy Aging Brain Center, said: "Having delirium prolongs the length of a hospital stay, increases the risk of post-hospitalization transfer to a nursing home, increases the risk of death and may lead to permanent brain damage."