Delirium is a serious and potentially life-threatening condition that can occur in people of all ages. It is generally characterized by an abrupt onset, fluctuating course, and disturbance in attention and awareness.
Delirium is often under-recognized and under-diagnosed, particularly in older adults, who are at increased risk for developing this condition.
What is Delirium?
Delirium, also known as acute confusional state, is a serious disturbance in mental function that results in confused thinking and reduced awareness of one’s surroundings.
The most common causes of delirium include medication side effects, infections, metabolic imbalances, and neurological disorders.
What are the Signs and Symptoms of Delirium?
The signs and symptoms of delirium can vary from person to person, depending on the underlying cause and the severity of the condition. Some of the most common signs and symptoms of delirium include:.
- Confusion and disorientation
- Reduced awareness of surroundings
- Changes in attention and concentration
- Memory problems
- Agitation and restlessness
- Emotional disturbances, such as anxiety or depression
- Sleep disturbances
- Altered perception, such as hallucinations or delusions
- Physical symptoms, such as tremors or seizures
- Fluctuations in symptoms from one hour to the next
What are the Risk Factors for Delirium?
Delirium can occur in people of all ages, but certain factors can increase the risk of developing this condition. Some of the most common risk factors for delirium include:.
- Older age
- Underlying medical conditions, such as dementia or Parkinson’s disease
- Recent hospitalization or surgery
- Use of certain medications or combinations of medications
- Drug or alcohol abuse
- Malnutrition or dehydration
- Medical procedures, such as intubation or dialysis
- Infections, particularly in the respiratory or urinary tract
- Trauma or injury to the brain or central nervous system
How is Delirium Diagnosed?
The diagnosis of delirium is based on a clinical assessment of the patient’s mental status and medical history.
To diagnose delirium, healthcare providers will typically perform a thorough physical examination, including a neurological evaluation, and order blood tests to check for underlying medical conditions.
In some cases, additional imaging studies, such as a CT scan or MRI, may be ordered to rule out a brain injury or neurological disorder.
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If an underlying medical condition is identified, such as an infection or electrolyte imbalance, it will be treated first to see if this resolves the delirium.
How is Delirium Treated?
The treatment of delirium depends on the underlying cause of the condition.
In general, the first step in treating delirium is to identify and address any underlying medical conditions, such as infections or metabolic imbalances, that may be contributing to the delirium.
Medications may be used to manage symptoms of delirium temporarily, such as antipsychotics to manage agitation or benzodiazepines to manage anxiety.
However, these medications should be used with caution, as they may worsen confusion or lead to other side effects.
Other interventions that may be used to manage symptoms of delirium include:.
- Environmental modifications, such as reducing noise and providing adequate lighting
- Reorientation techniques, such as using a familiar voice or music to help the patient focus
- Promotion of normal sleep and wake cycles
- Proper nutrition and hydration to address any underlying deficiencies
What is the Outlook for Delirium?
The outlook for delirium depends on the underlying cause of the condition, as well as how quickly it is diagnosed and treated. In general, delirium can be a serious and potentially life-threatening condition, particularly in older adults.
If left untreated, delirium can lead to a number of complications, including respiratory failure, pulmonary embolism, and cardiac arrest.
However, with prompt and appropriate treatment, many patients with delirium can recover and regain full cognitive function.
