Zawroty głowy (majaczenie)
Epidemiologia

Majaczenie jest powszechnym i poważnym problemem klinicznym, szczególnie u pacjentów geriatrycznych hospitalizowanych na oddziałach ogólnomedycznych, geriatrycznych oraz intensywnej terapii, gdzie częstość występowania sięga od 18% do nawet 80% (w OIT). Ryzyko wzrasta wraz z wiekiem, zwłaszcza powyżej 65 lat, a u osób powyżej 80 roku życia częstość majaczenia sięga 35%, a u pacjentów z demencją nawet 50%. Majaczenie wiąże się z istotnym wzrostem śmiertelności (14,5-37%, z 95% wzrostem ryzyka śmiertelności w metaanalizach), wydłużeniem hospitalizacji, zwiększonym ryzykiem powikłań, ponownej hospitalizacji oraz umieszczenia w placówkach opiekuńczych. Koszty opieki zdrowotnej związane z majaczeniem w USA szacuje się na 143-164 miliardy dolarów rocznie, a koszty na pacjenta wahają się od 16 303 do 64 421 USD. Czynniki ryzyka obejmują zaawansowany wiek, wcześniejsze zaburzenia poznawcze, ciężką chorobę, wielolekowość, zaburzenia sensoryczne oraz specyficzne czynniki środowiskowe i kliniczne, zwłaszcza w OIT.

  1. Epidemiologia zawrotów głowy (majaczenia)
    1. Częstość występowania u pacjentów hospitalizowanych
    2. Majaczenie u osób starszych
    3. Majaczenie w placówkach opiekuńczych
  2. Znaczenie kliniczne majaczenia
    1. Długoterminowe konsekwencje
    2. Wpływ ekonomiczny
  3. Czynniki ryzyka majaczenia
    1. Szczególne populacje ryzyka
  4. Metody nadzoru i wykrywania majaczenia
    1. Narzędzia przesiewowe
    2. Strategie nadzoru
  5. Strategie zapobiegania majaczeniu
    1. Podejścia niefarmakologiczne
    2. Aspekty farmakologiczne
  6. Wyzwania w badaniach nad majaczeniem
    1. Problemy metodologiczne
    2. Kierunki przyszłych badań
  7. Implikacje dla zdrowia publicznego
    1. Świadomość i edukacja
    2. Implikacje dla systemu opieki zdrowotnej
    3. Kolejne rozdziały

Epidemiologia zawrotów głowy (majaczenia)

Zawroty głowy (majaczenie) stanowią powszechny problem medyczny, szczególnie w populacji osób starszych. Szacuje się, że nawet 10-30% nowych przyjęć szpitalnych spełnia kryteria majaczenia, a częstość rozwoju majaczenia w trakcie hospitalizacji waha się od 3 do 29%.1 Całkowite koszty opieki zdrowotnej związane z majaczeniem szacuje się na 164 miliardy dolarów rocznie, co odzwierciedla znaczne obciążenie ekonomiczne systemów opieki zdrowotnej.2

Częstość występowania u pacjentów hospitalizowanych

Majaczenie dotyka około 1 na 7 dorosłych w szpitalu, a jego występowanie wzrasta wraz z wiekiem pacjenta.1 W oddziałach ogólnomedycznych i geriatrycznych częstość majaczenia wynosi 18-35%.2 Badania wskazują, że około 15-50% starszych pacjentów doświadcza majaczenia w pewnym momencie podczas pobytu w szpitalu.3 Szczególnie wysokie ryzyko występuje po zabiegach chirurgicznych, gdzie częstość majaczenia pooperacyjnego wynosi 5-10% po operacjach ogólnych i do 42% po zabiegach ortopedycznych.4

W oddziałach intensywnej terapii (OIT) problem staje się jeszcze poważniejszy – częstość występowania majaczenia może osiągać nawet 80%, szczególnie u pacjentów wentylowanych mechanicznie.5 W tych jednostkach obserwuje się zwiększone ryzyko majaczenia z powodu takich czynników jak izolacja, brak okien, częste przerywanie snu w celu kontroli parametrów życiowych i hałas z monitorów elektronicznych.6

Majaczenie u osób starszych

Częstość występowania majaczenia wzrasta znacząco z wiekiem, szczególnie u osób powyżej 65 roku życia. U osób powyżej 80 lat częstość występowania majaczenia sięga prawie 35%, podczas gdy u osób poniżej 50 lat wynosi mniej niż 5%.1 Szacuje się, że około 10% populacji powyżej 85 roku życia rozwija majaczenie.2 Badania wykazały, że częstość występowania majaczenia w społeczności ogólnej wynosi 1-2%, ale wzrasta do 14% u osób powyżej 85 roku życia.3

U pacjentów geriatrycznych majaczenie często nakłada się na istniejące wcześniej zaburzenia poznawcze. W szpitalach co najmniej połowa starszych pacjentów z majaczeniem ma również demencję.4 Osoby z demencją są szczególnie narażone na rozwój majaczenia – u ponad 80-letnich pacjentów z demencją przebywających w szpitalu ryzyko rozwoju majaczenia może sięgać nawet 50%.5

Majaczenie w placówkach opiekuńczych

W domach opieki i placówkach opieki długoterminowej częstość występowania majaczenia jest znacząca i waha się od 10% do 45%.1 W niektórych źródłach podaje się nawet szerszy zakres – od 1% do 60%, co odzwierciedla trudności w dokładnym ustaleniu skali problemu w tych placówkach.2 W placówkach opieki pooperacyjnej częstość występowania majaczenia może sięgać 60%.3

Majaczenie jest szczególnie powszechne wśród pensjonariuszy domów opieki, gdzie często współwystępuje z innymi syndromami geriatrycznymi, takimi jak demencja, depresja, niedożywienie, odleżyny, nadużycia wobec osób starszych, nietrzymanie moczu, przewlekły ból i upadki.4

Znaczenie kliniczne majaczenia

Majaczenie wiąże się z istotnymi negatywnymi konsekwencjami zdrowotnymi, zarówno krótko-, jak i długoterminowymi. U pacjentów zgłaszających się na oddział ratunkowy z majaczeniem występuje 70% zwiększone ryzyko zgonu w ciągu sześciu miesięcy, a majaczenie w OIT wiąże się z 2-4-krotnie zwiększonym ryzykiem ogólnej śmiertelności.1 Metaanaliza wykazała 95% zwiększone ryzyko śmiertelności u pacjentów z majaczeniem w porównaniu do pacjentów bez majaczenia, nawet po uwzględnieniu zmiennych zakłócających.2

Wskaźnik śmiertelności związany z majaczeniem u pacjentów w szpitalu szacuje się na 14,5% do 37%.3 Majaczenie wiąże się również z dłuższym czasem do ekstubacji i wydłużeniem pobytu zarówno w OIT, jak i w oddziałach ogólnomedycznych, co naraża pacjentów na dodatkowe powikłania medyczne związane z przedłużoną hospitalizacją.4

Długoterminowe konsekwencje

Majaczenie może mieć poważne konsekwencje długoterminowe. Choć u około 60% pacjentów objawy ustępują w ciągu 6 dni, około 1 na 20 osób (5%) może nadal doświadczać majaczenia ponad miesiąc po wystąpieniu pierwszych objawów.1 Badania wykazują, że pacjenci po epizodzie majaczenia stają przed zwiększonym ryzykiem umieszczenia w placówce opiekuńczej lub ponownej hospitalizacji.2

Majaczenie może prowadzić do długotrwałych problemów z funkcją mózgu, zdrowiem psychicznym, osłabienia mięśni i pogorszenia jakości życia, szczególnie jeśli nie zostanie zdiagnozowane i leczone.3 Niektórzy pacjenci nigdy nie wracają całkowicie do stanu sprzed wystąpienia majaczenia.4

Wpływ ekonomiczny

Majaczenie wiąże się ze znacznym obciążeniem ekonomicznym systemów opieki zdrowotnej. Szacowane koszty na jednego pacjenta wynoszą od 16 303 do 64 421 dolarów, a roczne obciążenie krajowe w Stanach Zjednoczonych wynosi 143-152 miliardy dolarów rocznie.1 Te wysokie koszty wynikają z przedłużonych pobytów w szpitalu, zwiększonego wykorzystania zasobów opieki zdrowotnej i powikłań związanych z majaczeniem.2

Czynniki ryzyka majaczenia

Identyfikacja czynników ryzyka majaczenia jest kluczowa dla wczesnej prewencji i interwencji. Do najważniejszych czynników ryzyka należą:

  • Zaawansowany wiek (szczególnie powyżej 65 lat, a ryzyko znacząco wzrasta po 80 roku życia)1
  • Wcześniejsze zaburzenia poznawcze lub demencja2
  • Ciężka choroba, zwłaszcza wymagająca intubacji3
  • Aktualne złamanie biodra4
  • Pobyt w szpitalu, szczególnie po operacji5
  • Wiele problemów medycznych6
  • Przyjmowanie wielu leków7
  • Problemy ze wzrokiem, słuchem lub zdolnością poruszania się8

W oddziale intensywnej terapii dodatkowe czynniki ryzyka obejmują: sepsę, historię nadciśnienia tętniczego, ból, udar, zaburzenia psychiatryczne i depresję, uraz mózgu, zawały serca, przewlekłą obturacyjną chorobę płuc, steroidy, leki wpływające na umysł, głębokie poziomy sedacji, czynniki środowiskowe jak brak światła słonecznego, unieruchomienie fizyczne i słabą jakość snu.1

Szczególne populacje ryzyka

Niektóre populacje są szczególnie narażone na rozwój majaczenia:

  • Pacjenci w stanie terminalnym – do 80% pacjentów rozwija majaczenie w pobliżu śmierci1
  • Pacjenci z urazami mózgu w rehabilitacji stacjonarnej – 69% spełnia kryteria majaczenia przy przyjęciu do rehabilitacji stacjonarnej2
  • Pacjenci po zabiegach kardiochirurgicznych, neurochirurgicznych, po urazach, radioterapii oraz pacjenci neurologiczni3
  • Pacjenci z demencją – szczególnie podatni ze względu na już istniejące zaburzenia poznawcze4

Metody nadzoru i wykrywania majaczenia

Pomimo powszechności majaczenia w populacji hospitalizowanych pacjentów, jest ono nadal niewykrywane w 32% do 66% przypadków.1 Badania sugerują, że między 1 na 3 a 2 na 3 przypadki majaczenia pozostają niezdiagnozowane.2 W związku z tym, systematyczne metody wykrywania majaczenia są kluczowe do poprawy rozpoznawania i leczenia tego stanu.

Narzędzia przesiewowe

Do najczęściej stosowanych narzędzi diagnostycznych w ocenie majaczenia należą:

  • Confusion Assessment Method (CAM) – zalecany przez wytyczne NICE do diagnozy majaczenia. Jest to jedno z najbardziej zwalidowanych narzędzi.1
  • Confusion Assessment Method for the ICU (CAM-ICU) – zwalidowane i łatwe w implementacji narzędzie dla pacjentów w OIT.2
  • Intensive Care Delirium Screening Checklist (ICDSC) – alternatywne narzędzie stosowane w OIT.3
  • Single Question in Delirium test – proste narzędzie, które może wykryć 80% pacjentów z majaczeniem, zadając pytanie: „Czy uważasz, że [imię pacjenta] był ostatnio bardziej zdezorientowany?”4
  • Family Confusion Assessment Method – zwalidowane narzędzie przesiewowe, które może być używane przez przeszkolonych członków rodziny do wykrywania majaczenia.5

Strategie nadzoru

Skuteczne strategie nadzoru nad majaczeniem obejmują:

  • Rutynową ocenę majaczenia u wszystkich pacjentów wysokiego ryzyka przy przyjęciu i podczas całego pobytu w szpitalu1
  • Szkolenie personelu pielęgniarskiego, asystentów opieki domowej i członków rodziny/opiekunów w zakresie rozpoznawania i leczenia majaczenia2
  • Wdrożenie wieloskładnikowego, niefarmakologicznego podejścia w przypadku osób z grupy ryzyka3
  • Stosowanie standardowych narzędzi diagnostycznych w różnych warunkach klinicznych4

Program Hospital Elder Life Program opracował narzędzia, które mogą być stosowane przez przeszkolonych członków rodziny do wykrywania majaczenia, co zwiększa możliwości wczesnego wykrywania.1

Strategie zapobiegania majaczeniu

Zapobieganie majaczeniu jest kluczowym aspektem opieki, szczególnie u pacjentów wysokiego ryzyka. Badania wykazały, że wieloskładnikowe podejście niefarmakologiczne jest wysoce skuteczne i zmniejsza liczbę oraz czas trwania epizodów majaczenia.1

Podejścia niefarmakologiczne

Zalecane interwencje niefarmakologiczne obejmują:

  • Leczenie infekcji, ale tylko wtedy, gdy rzeczywiście występuje1
  • Dbanie o odpowiednie nawodnienie i odżywienie2
  • Leczenie zaparć i bólu3
  • Identyfikacja i leczenie zatrzymania moczu4
  • Zachęcanie do mobilności5
  • Przegląd leków i minimalizacja stosowania sedatywów67
  • Edukacja i reorientacja pacjenta8
  • Stosowanie dużych, wyraźnie widocznych zegarów i kalendarzy9
  • Zapewnienie pacjentom opieki w znajomym środowisku przez znanych krewnych lub personel10

Aspekty farmakologiczne

W kontekście zapobiegania majaczeniu, ważne jest właściwe podejście do farmakoterapii:

  • Unikanie lub stosowanie niskich dawek leków sedatywnych1
  • Jeśli sedacja jest konieczna, powinna być stosowana w najniższej możliwej dawce przez jak najkrótszy czas2
  • Leki sedatywne powinny być odstawiane jak najszybciej, najlepiej w ciągu 24-48 godzin, a na pewno nie później niż po siedmiu dniach3
  • Szybkie leczenie zaburzeń metabolicznych i infekcji4

Stosowanie programów orientacji w rzeczywistości również może przyczynić się do zmniejszenia ryzyka majaczenia u osób z grupy wysokiego ryzyka.1

Wyzwania w badaniach nad majaczeniem

Badania epidemiologiczne nad majaczeniem napotykają liczne wyzwania. Jednym z kluczowych problemów jest brak badań opartych na populacji ogólnej, a większość wiedzy pochodzi z badań prowadzonych w wybranych populacjach klinicznych.1

Problemy metodologiczne

Główne wyzwania metodologiczne obejmują:

  • Trudności w standaryzacji definicji i kryteriów diagnostycznych majaczenia1
  • Zróżnicowane metody oceny majaczenia w różnych badaniach2
  • Zmienność w szacunkach częstości występowania majaczenia w zależności od badanej populacji, ram czasowych oceny i metody oceny3
  • Trudności w odseparowaniu majaczenia od innych stanów, takich jak demencja czy depresja4

Kierunki przyszłych badań

Przyszłe badania nad majaczeniem powinny skupić się na:

  • Rozwoju badań populacyjnych obejmujących szerszą, nieselekcjonowaną populację1
  • Opracowaniu i walidacji biomarkerów majaczenia w populacjach nieselekcjonowanych2
  • Lepszym zrozumieniu patofizjologii majaczenia3
  • Rozwoju skutecznych strategii zapobiegania i leczenia majaczenia4
  • Poprawie rozpoznawania i diagnozowania majaczenia w różnych warunkach klinicznych5

Optymalne projektowanie badań powinno rozpoczynać się od szerokiej, nieselekcjonowanej populacji (prawdziwe badanie populacyjne) z następczymi seryjnymi ocenami poznawczymi, nastroju i funkcjonalności.1

Implikacje dla zdrowia publicznego

Majaczenie stanowi poważne wyzwanie dla zdrowia publicznego ze względu na wysoką częstość występowania, istotne konsekwencje zdrowotne i znaczne koszty ekonomiczne.12

Świadomość i edukacja

Zwiększenie świadomości i edukacji na temat majaczenia jest kluczowe dla poprawy rozpoznawania i leczenia:1

  • Edukacja personelu medycznego w zakresie rozpoznawania i leczenia majaczenia1
  • Edukacja opiekunów na temat oznak i objawów majaczenia oraz stanów, które wymagałyby natychmiastowej oceny2
  • Zwiększenie świadomości społecznej na temat majaczenia jako poważnego stanu medycznego wymagającego natychmiastowej pomocy34

Implikacje dla systemu opieki zdrowotnej

Majaczenie ma istotne implikacje dla systemów opieki zdrowotnej:

  • Zwiększone wykorzystanie zasobów opieki zdrowotnej i wyższe koszty opieki1
  • Wydłużony pobyt w szpitalu i zwiększone ryzyko powikłań2
  • Zwiększone ryzyko umieszczenia w placówce opiekuńczej lub ponownej hospitalizacji3
  • Znaczące zwiększenie śmiertelności, niezależnie od czynników zakłócających4

Zapobieganie majaczeniu poprzez ukierunkowane interwencje u osób z grupy ryzyka może zmniejszyć częstość występowania majaczenia, koszty szpitalne i związane z nim negatywne wyniki.1

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

  1. 10.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Delirium: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/288890-overview
    Delirium is common in the United States. In a systematic review of 42 cohorts in 40 studies, 10-31% of new hospital admissions met criteria for delirium and the incidence of developing delirium during the admission ranged from 3-29%. […] For patients in intensive care units the prevalence of delirium may reach as high as 80%. […] Prevalence of postoperative delirium following general surgery is 5-10% and as high as 42% following orthopedic surgery. As many as 80% of patients develop delirium near death. Delirium is extremely common among nursing home residents. […] Delirium can occur at any age, but it occurs more commonly in patients who are elderly and have compromised mental status. Delirium can occur on top of an underlying dementia. This diagnosis here requires not only a careful mental status but also a thorough history from the patient’s family and the staff as well as a comprehensive chart review.
  • #1 Delirium | NHS inform
    https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/delirium/
    Delirium is one of the most common medical emergencies. Its found in around 1 in 7 adults in hospital and about half of patients in intensive care. […] Delirium comes on over hours or days and, in most cases, it will get better in a few days. […] The 2 conditions often co-exist, especially in older people. People with dementia are much more likely to develop delirium. In hospital at least half of older people with delirium will also have dementia.
  • #1 Delirium in an adult acute hospital population: predictors, prevalence and detection | BMJ Open
    https://bmjopen.bmj.com/content/3/1/e001772
    To date, delirium prevalence and incidence in acute hospitals has been estimated from pooled findings of studies performed in distinct patient populations. […] Our point prevalence study confirms that delirium occurs in about 1/5 of general hospital inpatients and particularly in those with prior cognitive impairment. […] Delirium is a very common problem in the acute hospital setting, with a point prevalence of approximately 20%. […] Advancing age and pre-existing cognitive impairment were independently associated with a higher prevalence of delirium, in keeping with previous studies. […] The prevalence of delirium among all medical patients in the hospital was 24.2% (39/161) whereas that of all general surgical specialities was 7.7% (6/78). […] Our prevalence figure of 20.7% represents the burden of delirium in a tertiary referral centre with regional neurosurgery and orthopaedic services and, hence, may not be reflective of all acute hospitals. […] The footprint of delirium in the hospital shows a predilection for older patients especially those with prior cognitive impairment, consistent with the literature that elderly are at the highest risk for delirium, where those over 80 had nearly 35% prevalence and those under 50 less than 5%.
  • #1 Delirium – Wikipedia
    https://en.wikipedia.org/wiki/Delirium
    A systematic review of delirium in general medical inpatients showed that estimates of delirium prevalence on admission ranged 10-31%. […] About 5-10% of older adults who are admitted to hospital develop a new episode of delirium while in hospital. […] Rates of delirium vary widely across general hospital wards. […] Estimates of the prevalence of delirium in nursing homes are between 10% and 45%.
  • #1 Delirium – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK470399/
    The prevalence of delirium is higher in the elderly population. It is a common surgical complication among older adults, with an incidence reported up to 10 to 20% after major elective surgery and up to 50% after high-risk procedures. […] Delirium in the general population increases healthcare utilization and is associated with increased complications and poor outcomes. The total healthcare cost attributable to delirium is estimated at $164 billion annually. In patients presenting to the emergency department with delirium, there is a 70% increased risk of death at six months, and delirium in the ICU is associated with a 2 to 4-fold increased risk of overall mortality.
  • #1 Delirium (sudden confusion) – Overview | Guy’s and St Thomas’ NHS Foundation Trust
    https://www.guysandstthomas.nhs.uk/health-information/delirium-sudden-confusion
    Delirium (sudden confusion) usually affects peoples brains for a short time. It is a common condition. Up to 1 in 3 people admitted to hospital become delirious at some time during their stay. […] Delirium can have different causes. We may need to do medical tests to help decide what treatment is needed. […] Delirium usually gets better. In 6 out of 10 people (60%), the symptoms disappear within 6 days. Others may have some symptoms for longer. About 1 in 20 people (5%) may still have delirium more than a month after they first had symptoms. […] Delirium is always a serious condition. Although many people make a full recovery, some people never get back to how they were completely.
  • #1
    https://scitemed.com/article/2687/Epidemiology,-Mechanisms,-Diagnosis,-and-Treatment-of-Delirium-A-Narrative-Review
    Of greatest concern, elderly patients with delirium face increased mortality, with a meta-analysis finding a 95% increased hazard for mortality for delirious patients compared to non-delirious controls, even after adjusting for confounding variables. […] Delirium is also associated with increased healthcare utilization, with estimated costs of between $16,303 to $64,421 per patient and an annual national burden of $143-152 billion per year in the United States.
  • #1 ICU Delirium – MD Searchlight
    https://mdsearchlight.com/health/icu-delirium/
    In the intensive care unit (ICU), delirium affects a whopping 70-87% of patients. […] Delirium entails a sudden and typically fluctuating change in an individuals mental state that affects attention and cognition. […] In intensive care units (ICUs), delirium can be caused by various factors such as already having dementia, needing a machine to help with breathing, sepsis, a history of high blood pressure, being very sick when admitted, pain, stroke, psychiatric disorders and depression, a traumatic brain injury, heart attacks, chronic obstructive pulmonary disease (COPD), steroids, high blood pressure, medications that affect the mind, deep levels of sedation, environmental factors like lack of sunlight, physical restraints, poor sleep quality, and other social factors like alcohol abuse, smoking, and lack of visitors. […] In the intensive care unit (ICU), delirium affects a whopping 70-87% of patients. […] Patients with delirium in the ICU have a lower survival rate after six months compared to patients without delirium.
  • #1 Delirium in Older Persons: Evaluation and Management | AAFP
    https://www.aafp.org/pubs/afp/issues/2014/0801/p150.html
    Delirium is common in older persons in hospitals and long-term care facilities, and it may indicate a life-threatening condition. […] Estimates of the prevalence of delirium vary based on the population studied, the timeframe in which delirium is assessed, and the method of assessment. […] Immediate and long-term outcomes associated with a delirium episode include increases in the risk of falls, length of hospital stay, hospital costs, duration of mechanical ventilation, degree of cognitive impairment, functional impairment after a hospital stay, long-term care facility placement, and mortality. […] Delirium is still missed in as many as 32% to 66% of cases. […] Assessing a patient’s medical disposition, physical and cognitive impairments, and social behaviors is essential for targeting at-risk patients with prevention strategies, as well as for identifying the multiple causes associated with a single delirium episode.
  • #1 14. CGA in Primary Care Settings: Patients presenting with confusion and delirium | British Geriatrics Society
    https://www.bgs.org.uk/resources/14-cga-in-primary-care-settings-patients-presenting-with-confusion-and-delirium
    The Single Question in Delirium test can pick up 80 per cent of patients with delirium by asking the question: „Do you think [patient’s name] has been more confused lately?” […] NICE guidance recommends use of the Confusion Assessment Method for diagnosis of delirium. […] Once delirium has been identified and diagnosed, a multifactorial assessment and management plan should be undertaken addressing the following features: Treat infection if it’s there, but only if it’s there. […] Address hydration status. […] Address nutritional status. […] Treat constipation. […] Treat pain. […] Identify, and treat urinary retention. […] Encourage mobility. […] Review medications. […] Drug/alcohol withdrawal. […] Assess sleep disturbance. […] Educate and re-orientate. […] The use of large, clearly visible clocks and calendars is recommended, and wherever possible patients should be looked after in a familiar environment by familiar relatives or staff. […] These medications should be avoided if at all possible, and if used, used at the lowest possible dose for as short a time as possible. […] If sedation is used then it should be reviewed and weaned as soon as possible, ideally within 24-48 hours, and certainly no more than seven days.
  • #1 Delirium in Older Persons: Evaluation and Management | AAFP
    https://www.aafp.org/pubs/afp/issues/2014/0801/p150.html
    Assessment for and prevention of delirium should occur at admission to the hospital and throughout the stay. […] Prevention efforts targeting persons at risk may decrease delirium incidence, hospital costs, and associated poor outcomes. […] Studies have demonstrated that a multicomponent nonpharmacologic approach is highly effective and reduces the number and duration of episodes of delirium. […] The Hospital Elder Life Program has also developed the Family Confusion Assessment Method, a validated screening tool that can be used by trained family members to detect delirium. […] A meta-analysis found that delirium in hospitalized older persons was associated with increased mortality, regardless of confounders such as age, sex, and comorbidities. […] The mortality rate associated with delirium in patients in the hospital is estimated to be 14.5% to 37%.
  • #1 Delirium: MedlinePlus Medical EncyclopediaLock
    https://medlineplus.gov/ency/article/000740.htm
    Delirium is sudden severe confusion due to rapid changes in brain function that can occur with physical or mental illness. […] Delirium is common in the intensive care unit (ICU), especially in older adults. […] Treating the conditions that cause delirium can reduce its risk. In hospitalized people, avoiding or using a low dosage of sedatives, prompt treatment of metabolic disorders and infections, and using reality orientation programs will reduce the risk of delirium in those at high risk.
  • #1 The Epidemiology of Delirium: Challenges and Opportunities for Population Studies
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3837358/
    Delirium is a serious and common acute neuropsychiatric syndrome that is associated with short- and long-term adverse health outcomes. […] Epidemiologic research in such populations has the potential to resolve several questions of clinical significance in delirium. […] Epidemiology is concerned with interrelationships between populations, exposures, and outcomes. The goal of the current article is to explore how the application of epidemiologic principles might provide opportunities for developments in delirium research. […] Most of these questions have been addressed by studies in a range of settings. However, very little delirium research has been undertaken from a population-based perspective. This is essential if we hope to contextualize the many strands of investigation, otherwise limited by virtue of selected samples, within a common denominator.
  • #1 The Epidemiology of Delirium: Challenges and Opportunities for Population Studies
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3837358/
    To understand how delirium relates to adverse cognitive outcomes, an optimal design would start with a broad, unselected denominator (i.e., a true population-based study) followed up with serial cognitive, mood, and functional assessments. […] For delirium research, we need to consider how explicitly the population is defined. […] It is clear that standardization is a complex issue in psychiatric epidemiology. At present, only clinical criteria can be used to define cases, although biomarkers may be promising if validated in unselected populations. […] Ultimately, validation studies of biomarkers could be undertaken in unselected populations, serving to improve delirium knowledge at the clinical and population levels.
  • #1 Home – Delirium Central
    https://www.deliriumcentral.org/
    Delirium is a common and serious problem for older adults and is characterized by sudden confusion or change in mental status. […] Delirium can have serious complications, including long-term functional decline, loss of independence, high healthcare costs, and even death. […] However, many cases of delirium are preventable, and managing and decreasing the complications of delirium can be accomplished with awareness and recognition of the problem. […] The goals of the American Delirium Society are to foster research, education, quality improvement, advocacy implementation science to minimize the impact of delirium on short- and long-term health and well-being of patients.
  • #1 Delirium in Older Persons: Evaluation and Management | AAFP
    https://www.aafp.org/pubs/afp/issues/2014/0801/p150.html
    Delirium shares risk factors with other geriatric syndromes, such as dementia, depression, malnutrition, pressure ulcers, elder abuse, urinary incontinence, chronic pain, and falls. […] Patients at high risk of delirium because of multiple or severe predisposing factors need minimal precipitators to provoke a delirium episode. […] Physicians should train nursing staff, home health aides, and family members/caregivers on recognizing and treating delirium. […] The prevalence of delirium in a long-term care facility is not firmly established, ranging from 1% to 60%. […] Hypoactive delirium is most common in the hospice or palliative care setting; it occurs in 20% to 83% of inpatients in palliative care units. […] Regardless of the setting, caregivers should be educated on the signs and symptoms of delirium and conditions that would indicate the need for immediate evaluation, including dramatic changes in vital signs, acute respiratory distress, chest pain, hematuria, and new-onset neurologic focal deficits.
  • #2 Delirium – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK470399/
    The prevalence of delirium is higher in the elderly population. It is a common surgical complication among older adults, with an incidence reported up to 10 to 20% after major elective surgery and up to 50% after high-risk procedures. […] Delirium in the general population increases healthcare utilization and is associated with increased complications and poor outcomes. The total healthcare cost attributable to delirium is estimated at $164 billion annually. In patients presenting to the emergency department with delirium, there is a 70% increased risk of death at six months, and delirium in the ICU is associated with a 2 to 4-fold increased risk of overall mortality.
  • #2 Prevalence and risk factors of delirium and subsyndromal delirium in older adults | The Egyptian Journal of Internal Medicine | Full Text
    https://ejim.springeropen.com/articles/10.1186/s43162-021-00042-3
    The prevalence of delirium alone was similar to the systemic review by Inouye et al. who demonstrated 18-35% of patients admitted in general medicine and geriatric wards had delirium. […] This study showed also that when delirium was classified according to psychomotor activity. Hypoactive type was found to be more common in our study. […] The current study showed also that hepatic encephalopathy was associated with hyperactive type of delirium. […] This is in accordance with Khor et al. who reported that 48.4% and 67.1% of patients had at least one feature of delirium on presentation to hospital from the CAM-S short and long severity scores, respectively, and the severity has also been shown to be inversely related to MMSE scores. […] The presence of even one or two symptoms of delirium may identify older people who warrant clinical attention, efforts to prevent, detect, and treat delirium and SSD must be justified.
  • #2 Delirium – USZ
    https://www.usz.ch/en/disease/delirium/
    Delirium is not a rare clinical picture and occurs more frequently today than in the past. […] In principle, acute confusion can occur at any age. However, delirium is most common in elderly people who suffer from several chronic illnesses. […] Doctors estimate that around 10 percent of the population over the age of 85 develop delirium. […] Delirium can have many different causes. […] The treatment team can prevent delirium, for example after an operation. […] The course and prognosis of delirium cannot be generally predicted. […] Delirium is potentially life-threatening and doctors often have to treat the acute state of confusion in the intensive care unit.
  • #2 Delirium in Older Persons: Evaluation and Management | AAFP
    https://www.aafp.org/pubs/afp/issues/2014/0801/p150.html
    Delirium shares risk factors with other geriatric syndromes, such as dementia, depression, malnutrition, pressure ulcers, elder abuse, urinary incontinence, chronic pain, and falls. […] Patients at high risk of delirium because of multiple or severe predisposing factors need minimal precipitators to provoke a delirium episode. […] Physicians should train nursing staff, home health aides, and family members/caregivers on recognizing and treating delirium. […] The prevalence of delirium in a long-term care facility is not firmly established, ranging from 1% to 60%. […] Hypoactive delirium is most common in the hospice or palliative care setting; it occurs in 20% to 83% of inpatients in palliative care units. […] Regardless of the setting, caregivers should be educated on the signs and symptoms of delirium and conditions that would indicate the need for immediate evaluation, including dramatic changes in vital signs, acute respiratory distress, chest pain, hematuria, and new-onset neurologic focal deficits.
  • #2
    https://scitemed.com/article/2687/Epidemiology,-Mechanisms,-Diagnosis,-and-Treatment-of-Delirium-A-Narrative-Review
    Of greatest concern, elderly patients with delirium face increased mortality, with a meta-analysis finding a 95% increased hazard for mortality for delirious patients compared to non-delirious controls, even after adjusting for confounding variables. […] Delirium is also associated with increased healthcare utilization, with estimated costs of between $16,303 to $64,421 per patient and an annual national burden of $143-152 billion per year in the United States.
  • #2
    https://scitemed.com/article/2687/Epidemiology,-Mechanisms,-Diagnosis,-and-Treatment-of-Delirium-A-Narrative-Review
    Delirium is a common syndrome that affects up to 30% of hospitalized adults. […] The prevalence varies significantly depending on the patient population, as patients with advanced age, cognitive decline, and more severe medical illness are at higher risk. […] In intensive care unit (ICU) settings the prevalence is significantly higher, where rates of over 80% have been reported in mechanically ventilated patients. […] Delirium is associated with a multitude of adverse clinical outcomes, including longer time to extubation and increases in length of stay in both ICU and general medical settings, thus putting patients at risk for additional medical complications associated with prolonged hospitalization. […] Patients also face an increased risk of nursing facility placement or hospital readmission, and, following surgery, are also at increased risk of post-operative complications.
  • #2 14. CGA in Primary Care Settings: Patients presenting with confusion and delirium | British Geriatrics Society
    https://www.bgs.org.uk/resources/14-cga-in-primary-care-settings-patients-presenting-with-confusion-and-delirium
    Delirium is a disorder in which there is an acute confusional state, usually with a fluctuating course, characterised by disturbed consciousness, cognitive function or perception. […] The prevalence of delirium in the community is 1-2 per cent although this rises to 14 per cent in people over the age of 85. In nursing homes, or post-acute care settings, prevalence may be even higher with figures up to 60 per cent. […] The cause for delirium in older people is usually multifactorial. […] Risk factors for delirium include: Age: over 65 years, Pre-existing cognitive impairment or dementia, Severe illness, Current hip fracture. […] Delirium should be suspected if there is: An acute confusional state, A change in perception e.g. visual or auditory hallucinations, A change in physical function e.g. reduced mobility, agitation, sleep disturbance, A change in social behaviour e.g. withdrawal, lack of co-operation for reasonable requests, alterations in mood, change in communication/attitude.
  • #2 Confusion (Delirium) Appears Common among Individuals in Inpatient Rehabilitation – Brain Injury Association of America
    https://biausa.org/professionals/research/tbi-model-systems/confusion-delirium-appears-common-among-individuals-in-inpatient-rehabilitation
    Delirium appears common among individuals with traumatic brain injury in inpatient rehabilitation. Sixty-nine percent of the individuals in this study met the criteria for delirium at the time of admission to inpatient rehabilitation. This rate is significantly higher than reported for individuals with other medical diagnoses in prior studies which typically included older individuals. […] The researchers argue that the standardized testing measures for post-traumatic amnesia alone do not capture all of the symptoms of the delirium. They state that the characteristics of post-traumatic confusion (delirium) must be identified for the individual to receive the most appropriate treatments and best outcomes. […] Overall, this group of individuals with traumatic brain injury had a higher incidence of delirium than reported in prior studies of individuals with other medical conditions (69% vs. 20%) which typically included older individuals.
  • #2 Delirium: What It Is, Symptoms, Treatment & Types
    https://my.clevelandclinic.org/health/diseases/15252-delirium
    Delirium is a fast-developing type of confusion that affects your ability to focus your attention and awareness. It happens when there’s widespread disruption in brain activity, usually because of a combination of factors. Delirium is more common in medical settings, such as during long hospital stays or in long-term care facilities. […] Research indicates that delirium affects between 18% and 35% of people admitted to a hospital for inpatient care. Up to 60% of people in an intensive care unit may experience delirium. However, researchers suspect delirium is more common than statistics indicate. The available research suggests that between 1 in 3 and 2 in 3 delirium cases go undiagnosed. […] Delirium is often preventable, but most preventive measures are things only clinical personnel should do. However, family, friends and loved ones can play a very important role in reducing the risk of delirium. […] The outlook for delirium can vary widely. In general, the outlook tends to be worse when delirium goes undiagnosed for long periods, or when it’s particularly severe.
  • #2 Delirium – Wikipedia
    https://en.wikipedia.org/wiki/Delirium
    The highest rates of delirium (often 50-75% of people) occur among those who are critically ill in the intensive care unit (ICU). […] Since the advent of validated and easy-to-implement delirium instruments for people admitted to the ICU such as the Confusion Assessment Method for the ICU (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC), it has been recognized that most ICU delirium is hypoactive, and can easily be missed unless evaluated regularly. […] Outside the ICU, on hospital wards and in nursing homes, the problem of delirium is also a very important medical problem, especially for older patients. […] The most recent area of the hospital in which delirium is just beginning to be monitored routinely in many centers is the Emergency Department, where the prevalence of delirium among older adults is about 10%.
  • #2 14. CGA in Primary Care Settings: Patients presenting with confusion and delirium | British Geriatrics Society
    https://www.bgs.org.uk/resources/14-cga-in-primary-care-settings-patients-presenting-with-confusion-and-delirium
    The Single Question in Delirium test can pick up 80 per cent of patients with delirium by asking the question: „Do you think [patient’s name] has been more confused lately?” […] NICE guidance recommends use of the Confusion Assessment Method for diagnosis of delirium. […] Once delirium has been identified and diagnosed, a multifactorial assessment and management plan should be undertaken addressing the following features: Treat infection if it’s there, but only if it’s there. […] Address hydration status. […] Address nutritional status. […] Treat constipation. […] Treat pain. […] Identify, and treat urinary retention. […] Encourage mobility. […] Review medications. […] Drug/alcohol withdrawal. […] Assess sleep disturbance. […] Educate and re-orientate. […] The use of large, clearly visible clocks and calendars is recommended, and wherever possible patients should be looked after in a familiar environment by familiar relatives or staff. […] These medications should be avoided if at all possible, and if used, used at the lowest possible dose for as short a time as possible. […] If sedation is used then it should be reviewed and weaned as soon as possible, ideally within 24-48 hours, and certainly no more than seven days.
  • #2 Diagnosis of delirium and confusional states – UpToDate
    https://www.uptodate.com/contents/diagnosis-of-delirium-and-confusional-states
    Knowledge of the clinical epidemiology of delirium and confusional states in various settings has substantially increased as a result of applying standardized diagnostic methods. […] The epidemiology, pathogenesis, clinical features, and diagnosis of delirium and confusional states will be reviewed here.
  • #2 The Epidemiology of Delirium: Challenges and Opportunities for Population Studies
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3837358/
    To understand how delirium relates to adverse cognitive outcomes, an optimal design would start with a broad, unselected denominator (i.e., a true population-based study) followed up with serial cognitive, mood, and functional assessments. […] For delirium research, we need to consider how explicitly the population is defined. […] It is clear that standardization is a complex issue in psychiatric epidemiology. At present, only clinical criteria can be used to define cases, although biomarkers may be promising if validated in unselected populations. […] Ultimately, validation studies of biomarkers could be undertaken in unselected populations, serving to improve delirium knowledge at the clinical and population levels.
  • #2 Delirium in Older Persons: Evaluation and Management | AAFP
    https://www.aafp.org/pubs/afp/issues/2014/0801/p150.html
    Delirium is common in older persons in hospitals and long-term care facilities, and it may indicate a life-threatening condition. […] Estimates of the prevalence of delirium vary based on the population studied, the timeframe in which delirium is assessed, and the method of assessment. […] Immediate and long-term outcomes associated with a delirium episode include increases in the risk of falls, length of hospital stay, hospital costs, duration of mechanical ventilation, degree of cognitive impairment, functional impairment after a hospital stay, long-term care facility placement, and mortality. […] Delirium is still missed in as many as 32% to 66% of cases. […] Assessing a patient’s medical disposition, physical and cognitive impairments, and social behaviors is essential for targeting at-risk patients with prevention strategies, as well as for identifying the multiple causes associated with a single delirium episode.
  • #3 Delirium – Neurologic Disorders – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/neurologic-disorders/delirium-and-dementia/delirium
    Delirium may occur at any age but is more common among older adults. At least 10% of older patients (65 years) who are admitted to the hospital have delirium; 15 to 50% experience delirium at some time during hospitalization, and it is particularly common after surgery and in patients admitted to an intensive care unit (ICU). […] For older patients in an ICU, risk of delirium (ICU psychosis) is particularly high. […] Delirium is more common among older adults. About 15 to 50% of older patients experience delirium at some time during a hospital stay. The risk of delirium is particularly high for older patients in an ICU (ICU psychosis). […] Because delirium greatly worsens prognosis for hospitalized patients, prevention should be emphasized. Hospital staff members should be trained to take measures to maintain orientation, mobility, and cognition and to ensure sleep, good nutrition and hydration, and sufficient pain relief, particularly in older patients.
  • #3 14. CGA in Primary Care Settings: Patients presenting with confusion and delirium | British Geriatrics Society
    https://www.bgs.org.uk/resources/14-cga-in-primary-care-settings-patients-presenting-with-confusion-and-delirium
    Delirium is a disorder in which there is an acute confusional state, usually with a fluctuating course, characterised by disturbed consciousness, cognitive function or perception. […] The prevalence of delirium in the community is 1-2 per cent although this rises to 14 per cent in people over the age of 85. In nursing homes, or post-acute care settings, prevalence may be even higher with figures up to 60 per cent. […] The cause for delirium in older people is usually multifactorial. […] Risk factors for delirium include: Age: over 65 years, Pre-existing cognitive impairment or dementia, Severe illness, Current hip fracture. […] Delirium should be suspected if there is: An acute confusional state, A change in perception e.g. visual or auditory hallucinations, A change in physical function e.g. reduced mobility, agitation, sleep disturbance, A change in social behaviour e.g. withdrawal, lack of co-operation for reasonable requests, alterations in mood, change in communication/attitude.
  • #3 Delirium in Older Persons: Evaluation and Management | AAFP
    https://www.aafp.org/pubs/afp/issues/2014/0801/p150.html
    Assessment for and prevention of delirium should occur at admission to the hospital and throughout the stay. […] Prevention efforts targeting persons at risk may decrease delirium incidence, hospital costs, and associated poor outcomes. […] Studies have demonstrated that a multicomponent nonpharmacologic approach is highly effective and reduces the number and duration of episodes of delirium. […] The Hospital Elder Life Program has also developed the Family Confusion Assessment Method, a validated screening tool that can be used by trained family members to detect delirium. […] A meta-analysis found that delirium in hospitalized older persons was associated with increased mortality, regardless of confounders such as age, sex, and comorbidities. […] The mortality rate associated with delirium in patients in the hospital is estimated to be 14.5% to 37%.
  • #3 ​​Risk Factors
    https://myhealth.alberta.ca/Alberta/Pages/what-is-icu-delirium.aspx
    Delirium can develop for many reasons, such as infection, certain medicines, and problems with blood sugar. […] People who are in an intensive care unit (ICU) are at risk of developing delirium, called ICU delirium. About 2 out of 3 people in the ICU develop ICU delirium, and people on breathing machines have the highest risk. […] It’s important to diagnose and treat ICU delirium as quickly as possible. Research shows that patients with ICU delirium who leave the hospital without treatment may have long-term problems with brain function, mental health, muscle weakness, and a poorer quality of life.
  • #3 Delirium & antipsychotic pharmacology – EMCrit Project
    https://emcrit.org/ibcc/delirium/
    Delirium is extremely common among critically ill patients (affecting ~50-80% of patients).(33758677) […] Risk of delirium correlates with: Older age. Low cognitive reserve (e.g., baseline dementia). Comorbidities (including alcohol or substance use disorder). Illness severity (especially intubation). […] CAM-ICU is a bedside test to detect delirium among ICU patients. It is often used in clinical research. […] Rather than screening for delirium, the best global strategy to reduce delirium in the ICU is to apply delirium prevention strategies to all patients in the ICU. Evidence supporting primary prevention of delirium is more robust than evidence supporting early detection and intervention.(12389836)
  • #3 Delirium vs. dementia: Compare causes, symptoms, treatments, more
    https://www.singlecare.com/blog/delirium-vs-dementia/
    Delirium affects 15%-50% of older adults during hospital stays and is most common post-surgery or in intensive care, whereas dementia affects 50 million people globally, with Alzheimers being the most prevalent form. […] According to the Merck Manual, around 15%-50% of older people experience delirium at some time during a hospital stay. One study found that delirium was most prevalent in those who had cardiac surgery, neurosurgery, trauma, radiotherapy, and neurology patients. Intensive Care Unit (ICU) delirium, associated with an increased ICU length of stay, has a prevalence estimated at 31.8% as determined by a 2018 study. […] Symptoms of delirium typically have a sudden onset. They are also typically in response to a medical issue. Symptoms include: Confusion, Disorientation, Paranoia, Hallucinations, Agitation, Somnolence, Short-term memory impairment, Problems with attention and cognition.
  • #3 Delirium – Wikipedia
    https://en.wikipedia.org/wiki/Delirium
    The highest rates of delirium (often 50-75% of people) occur among those who are critically ill in the intensive care unit (ICU). […] Since the advent of validated and easy-to-implement delirium instruments for people admitted to the ICU such as the Confusion Assessment Method for the ICU (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC), it has been recognized that most ICU delirium is hypoactive, and can easily be missed unless evaluated regularly. […] Outside the ICU, on hospital wards and in nursing homes, the problem of delirium is also a very important medical problem, especially for older patients. […] The most recent area of the hospital in which delirium is just beginning to be monitored routinely in many centers is the Emergency Department, where the prevalence of delirium among older adults is about 10%.
  • #3 14. CGA in Primary Care Settings: Patients presenting with confusion and delirium | British Geriatrics Society
    https://www.bgs.org.uk/resources/14-cga-in-primary-care-settings-patients-presenting-with-confusion-and-delirium
    The Single Question in Delirium test can pick up 80 per cent of patients with delirium by asking the question: „Do you think [patient’s name] has been more confused lately?” […] NICE guidance recommends use of the Confusion Assessment Method for diagnosis of delirium. […] Once delirium has been identified and diagnosed, a multifactorial assessment and management plan should be undertaken addressing the following features: Treat infection if it’s there, but only if it’s there. […] Address hydration status. […] Address nutritional status. […] Treat constipation. […] Treat pain. […] Identify, and treat urinary retention. […] Encourage mobility. […] Review medications. […] Drug/alcohol withdrawal. […] Assess sleep disturbance. […] Educate and re-orientate. […] The use of large, clearly visible clocks and calendars is recommended, and wherever possible patients should be looked after in a familiar environment by familiar relatives or staff. […] These medications should be avoided if at all possible, and if used, used at the lowest possible dose for as short a time as possible. […] If sedation is used then it should be reviewed and weaned as soon as possible, ideally within 24-48 hours, and certainly no more than seven days.
  • #3 Delirium in Older Persons: Evaluation and Management | AAFP
    https://www.aafp.org/pubs/afp/issues/2014/0801/p150.html
    Delirium is common in older persons in hospitals and long-term care facilities, and it may indicate a life-threatening condition. […] Estimates of the prevalence of delirium vary based on the population studied, the timeframe in which delirium is assessed, and the method of assessment. […] Immediate and long-term outcomes associated with a delirium episode include increases in the risk of falls, length of hospital stay, hospital costs, duration of mechanical ventilation, degree of cognitive impairment, functional impairment after a hospital stay, long-term care facility placement, and mortality. […] Delirium is still missed in as many as 32% to 66% of cases. […] Assessing a patient’s medical disposition, physical and cognitive impairments, and social behaviors is essential for targeting at-risk patients with prevention strategies, as well as for identifying the multiple causes associated with a single delirium episode.
  • #3 What is delirium? Symptoms, causes, diagnosis, and treatment
    https://www.medicalnewstoday.com/articles/326684
    Delirium is a sudden change in a persons mental function. This can include their ways of thinking, behavior, or level of consciousness. […] Medical professionals do not yet fully understand delirium, but it seems to have an association with older age, alcohol withdrawal, and certain medical conditions. […] According to the authors of a 2013 article, there is a link between delirium and adverse health outcomes, such as extended hospital stays, faster cognitive decline, and a higher likelihood of developing dementia. […] Delirium remains a poorly understood and potentially underdiagnosed condition. […] People over the age of 70 years have a higher risk of delirium. […] Infections, chemical imbalances, and certain medications can cause delirium. Early diagnosis and prompt treatment may decrease the risk of future complications.
  • #3 Sudden confusion (delirium)
    https://www.nhs.uk/conditions/confusion/
    Sudden confusion (delirium) can have many different causes. Get medical help immediately if someone suddenly becomes confused (delirious). […] Many causes of sudden confusion need to be assessed and treated as soon as possible. Sometimes it may be life threatening. […] Sudden confusion can be caused by many different things. Do not try to self-diagnose. Get medical help if someone suddenly becomes confused or delirious. […] Some of the most common causes of sudden confusion include: an infection urinary tract infections (UTIs) are a common cause in older people or people with dementia, a stroke or TIA („mini-stroke”), a low blood sugar level in people with diabetes, a head injury, some types of prescription medicine, alcohol poisoning or alcohol withdrawal, taking drugs, carbon monoxide poisoning especially if other people you live with also become unwell, a severe asthma attack or other problems with the lungs or heart, certain types of seizures caused by epilepsy.
  • #3
    https://scitemed.com/article/2687/Epidemiology,-Mechanisms,-Diagnosis,-and-Treatment-of-Delirium-A-Narrative-Review
    Delirium is a common syndrome that affects up to 30% of hospitalized adults. […] The prevalence varies significantly depending on the patient population, as patients with advanced age, cognitive decline, and more severe medical illness are at higher risk. […] In intensive care unit (ICU) settings the prevalence is significantly higher, where rates of over 80% have been reported in mechanically ventilated patients. […] Delirium is associated with a multitude of adverse clinical outcomes, including longer time to extubation and increases in length of stay in both ICU and general medical settings, thus putting patients at risk for additional medical complications associated with prolonged hospitalization. […] Patients also face an increased risk of nursing facility placement or hospital readmission, and, following surgery, are also at increased risk of post-operative complications.
  • #4 Delirium: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/288890-overview
    Delirium is common in the United States. In a systematic review of 42 cohorts in 40 studies, 10-31% of new hospital admissions met criteria for delirium and the incidence of developing delirium during the admission ranged from 3-29%. […] For patients in intensive care units the prevalence of delirium may reach as high as 80%. […] Prevalence of postoperative delirium following general surgery is 5-10% and as high as 42% following orthopedic surgery. As many as 80% of patients develop delirium near death. Delirium is extremely common among nursing home residents. […] Delirium can occur at any age, but it occurs more commonly in patients who are elderly and have compromised mental status. Delirium can occur on top of an underlying dementia. This diagnosis here requires not only a careful mental status but also a thorough history from the patient’s family and the staff as well as a comprehensive chart review.
  • #4 Delirium | NHS inform
    https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/delirium/
    Delirium is one of the most common medical emergencies. Its found in around 1 in 7 adults in hospital and about half of patients in intensive care. […] Delirium comes on over hours or days and, in most cases, it will get better in a few days. […] The 2 conditions often co-exist, especially in older people. People with dementia are much more likely to develop delirium. In hospital at least half of older people with delirium will also have dementia.
  • #4 Delirium in Older Persons: Evaluation and Management | AAFP
    https://www.aafp.org/pubs/afp/issues/2014/0801/p150.html
    Delirium shares risk factors with other geriatric syndromes, such as dementia, depression, malnutrition, pressure ulcers, elder abuse, urinary incontinence, chronic pain, and falls. […] Patients at high risk of delirium because of multiple or severe predisposing factors need minimal precipitators to provoke a delirium episode. […] Physicians should train nursing staff, home health aides, and family members/caregivers on recognizing and treating delirium. […] The prevalence of delirium in a long-term care facility is not firmly established, ranging from 1% to 60%. […] Hypoactive delirium is most common in the hospice or palliative care setting; it occurs in 20% to 83% of inpatients in palliative care units. […] Regardless of the setting, caregivers should be educated on the signs and symptoms of delirium and conditions that would indicate the need for immediate evaluation, including dramatic changes in vital signs, acute respiratory distress, chest pain, hematuria, and new-onset neurologic focal deficits.
  • #4
    https://scitemed.com/article/2687/Epidemiology,-Mechanisms,-Diagnosis,-and-Treatment-of-Delirium-A-Narrative-Review
    Delirium is a common syndrome that affects up to 30% of hospitalized adults. […] The prevalence varies significantly depending on the patient population, as patients with advanced age, cognitive decline, and more severe medical illness are at higher risk. […] In intensive care unit (ICU) settings the prevalence is significantly higher, where rates of over 80% have been reported in mechanically ventilated patients. […] Delirium is associated with a multitude of adverse clinical outcomes, including longer time to extubation and increases in length of stay in both ICU and general medical settings, thus putting patients at risk for additional medical complications associated with prolonged hospitalization. […] Patients also face an increased risk of nursing facility placement or hospital readmission, and, following surgery, are also at increased risk of post-operative complications.
  • #4 Delirium (sudden confusion) – Overview | Guy’s and St Thomas’ NHS Foundation Trust
    https://www.guysandstthomas.nhs.uk/health-information/delirium-sudden-confusion
    Delirium (sudden confusion) usually affects peoples brains for a short time. It is a common condition. Up to 1 in 3 people admitted to hospital become delirious at some time during their stay. […] Delirium can have different causes. We may need to do medical tests to help decide what treatment is needed. […] Delirium usually gets better. In 6 out of 10 people (60%), the symptoms disappear within 6 days. Others may have some symptoms for longer. About 1 in 20 people (5%) may still have delirium more than a month after they first had symptoms. […] Delirium is always a serious condition. Although many people make a full recovery, some people never get back to how they were completely.
  • #4 14. CGA in Primary Care Settings: Patients presenting with confusion and delirium | British Geriatrics Society
    https://www.bgs.org.uk/resources/14-cga-in-primary-care-settings-patients-presenting-with-confusion-and-delirium
    Delirium is a disorder in which there is an acute confusional state, usually with a fluctuating course, characterised by disturbed consciousness, cognitive function or perception. […] The prevalence of delirium in the community is 1-2 per cent although this rises to 14 per cent in people over the age of 85. In nursing homes, or post-acute care settings, prevalence may be even higher with figures up to 60 per cent. […] The cause for delirium in older people is usually multifactorial. […] Risk factors for delirium include: Age: over 65 years, Pre-existing cognitive impairment or dementia, Severe illness, Current hip fracture. […] Delirium should be suspected if there is: An acute confusional state, A change in perception e.g. visual or auditory hallucinations, A change in physical function e.g. reduced mobility, agitation, sleep disturbance, A change in social behaviour e.g. withdrawal, lack of co-operation for reasonable requests, alterations in mood, change in communication/attitude.
  • #4 Delirium (sudden confusion) – Dementia UK
    https://www.dementiauk.org/information-and-support/health-advice/delirium/
    Delirium is common in people with dementia and can make them increasingly confused and distressed. Here, we explain the signs to be aware of and how you can help. […] Delirium is a state of mental confusion that comes on suddenly. It can have a big impact on the way a person behaves and functions, especially if they have dementia. […] Dementia can make people more likely to experience delirium. People who are over 80 and live with dementia are at greater risk, particularly during a hospital stay, when up to 50% of people with dementia develop delirium. […] About 60% of people with delirium recover within a week. Some people, however, take longer to recover, and some never get back to exactly how they were before – this is more likely if they have dementia.
  • #4 14. CGA in Primary Care Settings: Patients presenting with confusion and delirium | British Geriatrics Society
    https://www.bgs.org.uk/resources/14-cga-in-primary-care-settings-patients-presenting-with-confusion-and-delirium
    The Single Question in Delirium test can pick up 80 per cent of patients with delirium by asking the question: „Do you think [patient’s name] has been more confused lately?” […] NICE guidance recommends use of the Confusion Assessment Method for diagnosis of delirium. […] Once delirium has been identified and diagnosed, a multifactorial assessment and management plan should be undertaken addressing the following features: Treat infection if it’s there, but only if it’s there. […] Address hydration status. […] Address nutritional status. […] Treat constipation. […] Treat pain. […] Identify, and treat urinary retention. […] Encourage mobility. […] Review medications. […] Drug/alcohol withdrawal. […] Assess sleep disturbance. […] Educate and re-orientate. […] The use of large, clearly visible clocks and calendars is recommended, and wherever possible patients should be looked after in a familiar environment by familiar relatives or staff. […] These medications should be avoided if at all possible, and if used, used at the lowest possible dose for as short a time as possible. […] If sedation is used then it should be reviewed and weaned as soon as possible, ideally within 24-48 hours, and certainly no more than seven days.
  • #4 The Epidemiology of Delirium: Challenges and Opportunities for Population Studies
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3837358/
    To understand how delirium relates to adverse cognitive outcomes, an optimal design would start with a broad, unselected denominator (i.e., a true population-based study) followed up with serial cognitive, mood, and functional assessments. […] For delirium research, we need to consider how explicitly the population is defined. […] It is clear that standardization is a complex issue in psychiatric epidemiology. At present, only clinical criteria can be used to define cases, although biomarkers may be promising if validated in unselected populations. […] Ultimately, validation studies of biomarkers could be undertaken in unselected populations, serving to improve delirium knowledge at the clinical and population levels.
  • #4 Delirium: MedlinePlus Medical EncyclopediaLock
    https://medlineplus.gov/ency/article/000740.htm
    Delirium is sudden severe confusion due to rapid changes in brain function that can occur with physical or mental illness. […] Delirium is common in the intensive care unit (ICU), especially in older adults. […] Treating the conditions that cause delirium can reduce its risk. In hospitalized people, avoiding or using a low dosage of sedatives, prompt treatment of metabolic disorders and infections, and using reality orientation programs will reduce the risk of delirium in those at high risk.
  • #4 Delirium: Definition, Causes, and What It Feels Like
    https://www.verywellhealth.com/delirium-5223127
    Delirium is common in hospitalized or seriously ill older adults but can also result from infections, surgery, medications, or substance withdrawal. […] Delirium tends to be common among older adults, especially in hospital settings. By some estimates, up to 30% of older hospitalized people experience delirium. […] Delirium is particularly common among people over 80. However, anyone can experience delirium, especially if they are using drugs or alcohol, have recently had surgery, or have a chronic or terminal illness. […] Some estimates suggest that up to two-thirds of cases of delirium in hospital settings are missed or misdiagnosed. Signs of delirium may sometimes be confused with symptoms of dementia, depression, or fatigue. […] Delirium is most common in hospitalized older adults, especially in the ICU. It can result from severe illness, infection, alcohol withdrawal, dehydration, or recent surgery.
  • #4 Home – Delirium Central
    https://www.deliriumcentral.org/
    Delirium is a common and serious problem for older adults and is characterized by sudden confusion or change in mental status. […] Delirium can have serious complications, including long-term functional decline, loss of independence, high healthcare costs, and even death. […] However, many cases of delirium are preventable, and managing and decreasing the complications of delirium can be accomplished with awareness and recognition of the problem. […] The goals of the American Delirium Society are to foster research, education, quality improvement, advocacy implementation science to minimize the impact of delirium on short- and long-term health and well-being of patients.
  • #4
    https://111.wales.nhs.uk/confusion(delirium)/
    Sudden confusion (delirium) can have many different causes. Get medical help immediately if someone becomes confused (delirious). […] Many causes of sudden confusion need to be assessed and treated as soon as possible. Sometimes it may be life threatening. […] Sudden confusion can be caused by many different things. Do not try to self-diagnose. Get medical help if someone suddenly becomes confused or delirious.
  • #4 Delirium in Older Persons: Evaluation and Management | AAFP
    https://www.aafp.org/pubs/afp/issues/2014/0801/p150.html
    Assessment for and prevention of delirium should occur at admission to the hospital and throughout the stay. […] Prevention efforts targeting persons at risk may decrease delirium incidence, hospital costs, and associated poor outcomes. […] Studies have demonstrated that a multicomponent nonpharmacologic approach is highly effective and reduces the number and duration of episodes of delirium. […] The Hospital Elder Life Program has also developed the Family Confusion Assessment Method, a validated screening tool that can be used by trained family members to detect delirium. […] A meta-analysis found that delirium in hospitalized older persons was associated with increased mortality, regardless of confounders such as age, sex, and comorbidities. […] The mortality rate associated with delirium in patients in the hospital is estimated to be 14.5% to 37%.
  • #5 ICU Delirium – MD Searchlight
    https://mdsearchlight.com/health/icu-delirium/
    Delirium, often called an acute confused state, toxic or metabolic brain disease, or acute brain failure, is basically a rapid change in focus and awareness. These changes typically develop suddenly and can be accompanied by other cognitive problems like memory loss, disorientation, or disturbances in perception. Delirium is common, happening in about 20 to 70% of patients in a hospital. […] Many studies have shown that delirium is even more common among ICU patients on breathing machines, affecting up to 80% of such patients. […] Since delirium is the most frequently seen sign of sudden brain function issues in ICU patients, particularly among those on breathing machines, any new confusion in an adult patient should always be checked out. […] Delirium, a sudden disturbance in mental function, is more common as people age.
  • #5 Delirium (sudden confusion) – Dementia UK
    https://www.dementiauk.org/information-and-support/health-advice/delirium/
    Delirium is common in people with dementia and can make them increasingly confused and distressed. Here, we explain the signs to be aware of and how you can help. […] Delirium is a state of mental confusion that comes on suddenly. It can have a big impact on the way a person behaves and functions, especially if they have dementia. […] Dementia can make people more likely to experience delirium. People who are over 80 and live with dementia are at greater risk, particularly during a hospital stay, when up to 50% of people with dementia develop delirium. […] About 60% of people with delirium recover within a week. Some people, however, take longer to recover, and some never get back to exactly how they were before – this is more likely if they have dementia.
  • #5 Temporary Confusion & Disorientation (Delirium): Causes & Treatment
    https://www.webmd.com/brain/sudden-confusion-causes
    Sudden confusion, sometimes called delirium or encephalopathy, can be a sign of many health problems. It comes on quickly, within hours or days. Its different from dementia (like Alzheimers disease), which causes slow changes over months or years. […] Many conditions or health problems can cause sudden confusion, and some are more serious than others: They include: Alcohol or drug abuse, Carbon monoxide poisoning, Very low amounts of sodium or calcium in your body, Diabetes (especially low blood sugar or high blood sugar levels), Infections anywhere in the body (including the brain, lungs, and urinary tract). This is especially common for older people. […] Other things can also make you more likely to have sudden confusion, such as if you: Stay in the hospital, especially after an operation, Have a lot of medical problems, Take a lot of medications, or stop taking a daily medication, Are over age 65, Have dementia, Dont eat or drink enough, Are very overtired, Have problems with sight, hearing, or how well you get around.
  • #5 Delirium in Older Persons: Evaluation and Management | AAFP
    https://www.aafp.org/pubs/afp/issues/2014/0801/p150.html
    Assessment for and prevention of delirium should occur at admission to the hospital and throughout the stay. […] Prevention efforts targeting persons at risk may decrease delirium incidence, hospital costs, and associated poor outcomes. […] Studies have demonstrated that a multicomponent nonpharmacologic approach is highly effective and reduces the number and duration of episodes of delirium. […] The Hospital Elder Life Program has also developed the Family Confusion Assessment Method, a validated screening tool that can be used by trained family members to detect delirium. […] A meta-analysis found that delirium in hospitalized older persons was associated with increased mortality, regardless of confounders such as age, sex, and comorbidities. […] The mortality rate associated with delirium in patients in the hospital is estimated to be 14.5% to 37%.
  • #5 14. CGA in Primary Care Settings: Patients presenting with confusion and delirium | British Geriatrics Society
    https://www.bgs.org.uk/resources/14-cga-in-primary-care-settings-patients-presenting-with-confusion-and-delirium
    The Single Question in Delirium test can pick up 80 per cent of patients with delirium by asking the question: „Do you think [patient’s name] has been more confused lately?” […] NICE guidance recommends use of the Confusion Assessment Method for diagnosis of delirium. […] Once delirium has been identified and diagnosed, a multifactorial assessment and management plan should be undertaken addressing the following features: Treat infection if it’s there, but only if it’s there. […] Address hydration status. […] Address nutritional status. […] Treat constipation. […] Treat pain. […] Identify, and treat urinary retention. […] Encourage mobility. […] Review medications. […] Drug/alcohol withdrawal. […] Assess sleep disturbance. […] Educate and re-orientate. […] The use of large, clearly visible clocks and calendars is recommended, and wherever possible patients should be looked after in a familiar environment by familiar relatives or staff. […] These medications should be avoided if at all possible, and if used, used at the lowest possible dose for as short a time as possible. […] If sedation is used then it should be reviewed and weaned as soon as possible, ideally within 24-48 hours, and certainly no more than seven days.
  • #5 Initial Steps for Nurses When a Patient Shows Confusion
    https://www.nursemagic.ai/post/initial-steps-for-nurses-when-a-patient-shows-confusion
    Confusion, or mental disorientation, can manifest as difficulty making decisions, memory problems, or erratic behavior. Nurses need to distinguish between sudden confusion (delirium) and more gradual cognitive declines such as dementia. The prevalence of delirium in hospitalized patients is significant. Studies show that nearly 30 percent of older patients experience delirium at some time during hospitalization; the incidence is higher in intensive care units. Among older patients who have had surgery, the risk of delirium varies from 10 to greater than 50 percent. […] With 35.4% of patients with delirium not recognized by the treating team, the role of the nurse in quickly identifying and mitigating confusion has never been more critical.
  • #6 Seniors at Risk for Delirium
    https://www.uspharmacist.com/article/seniors-at-risk-for-delirium
    Further, when a senior is hospitalized in the intensive care unit (ICU), the risk of delirium (ICU psychosis) is especially high.5 The isolation, lack of windows, frequent interruption of sleep for vital sign checks, and noisy electronic monitors contribute to the disorienting effect of the ICU experience. […] Delirium (e.g., sudden confusion) is particularly common in the dying patient. Confusion may be attributed not only to medication intervention (e.g., for anxiety, pain, and shortness of breath) at this end-of-life stage, but also to conditions such as dehydration and sleep impairment.
  • #6 Temporary Confusion & Disorientation (Delirium): Causes & Treatment
    https://www.webmd.com/brain/sudden-confusion-causes
    Sudden confusion, sometimes called delirium or encephalopathy, can be a sign of many health problems. It comes on quickly, within hours or days. Its different from dementia (like Alzheimers disease), which causes slow changes over months or years. […] Many conditions or health problems can cause sudden confusion, and some are more serious than others: They include: Alcohol or drug abuse, Carbon monoxide poisoning, Very low amounts of sodium or calcium in your body, Diabetes (especially low blood sugar or high blood sugar levels), Infections anywhere in the body (including the brain, lungs, and urinary tract). This is especially common for older people. […] Other things can also make you more likely to have sudden confusion, such as if you: Stay in the hospital, especially after an operation, Have a lot of medical problems, Take a lot of medications, or stop taking a daily medication, Are over age 65, Have dementia, Dont eat or drink enough, Are very overtired, Have problems with sight, hearing, or how well you get around.
  • #6 14. CGA in Primary Care Settings: Patients presenting with confusion and delirium | British Geriatrics Society
    https://www.bgs.org.uk/resources/14-cga-in-primary-care-settings-patients-presenting-with-confusion-and-delirium
    The Single Question in Delirium test can pick up 80 per cent of patients with delirium by asking the question: „Do you think [patient’s name] has been more confused lately?” […] NICE guidance recommends use of the Confusion Assessment Method for diagnosis of delirium. […] Once delirium has been identified and diagnosed, a multifactorial assessment and management plan should be undertaken addressing the following features: Treat infection if it’s there, but only if it’s there. […] Address hydration status. […] Address nutritional status. […] Treat constipation. […] Treat pain. […] Identify, and treat urinary retention. […] Encourage mobility. […] Review medications. […] Drug/alcohol withdrawal. […] Assess sleep disturbance. […] Educate and re-orientate. […] The use of large, clearly visible clocks and calendars is recommended, and wherever possible patients should be looked after in a familiar environment by familiar relatives or staff. […] These medications should be avoided if at all possible, and if used, used at the lowest possible dose for as short a time as possible. […] If sedation is used then it should be reviewed and weaned as soon as possible, ideally within 24-48 hours, and certainly no more than seven days.
  • #7 Temporary Confusion & Disorientation (Delirium): Causes & Treatment
    https://www.webmd.com/brain/sudden-confusion-causes
    Sudden confusion, sometimes called delirium or encephalopathy, can be a sign of many health problems. It comes on quickly, within hours or days. Its different from dementia (like Alzheimers disease), which causes slow changes over months or years. […] Many conditions or health problems can cause sudden confusion, and some are more serious than others: They include: Alcohol or drug abuse, Carbon monoxide poisoning, Very low amounts of sodium or calcium in your body, Diabetes (especially low blood sugar or high blood sugar levels), Infections anywhere in the body (including the brain, lungs, and urinary tract). This is especially common for older people. […] Other things can also make you more likely to have sudden confusion, such as if you: Stay in the hospital, especially after an operation, Have a lot of medical problems, Take a lot of medications, or stop taking a daily medication, Are over age 65, Have dementia, Dont eat or drink enough, Are very overtired, Have problems with sight, hearing, or how well you get around.
  • #7 Delirium: MedlinePlus Medical EncyclopediaLock
    https://medlineplus.gov/ency/article/000740.htm
    Delirium is sudden severe confusion due to rapid changes in brain function that can occur with physical or mental illness. […] Delirium is common in the intensive care unit (ICU), especially in older adults. […] Treating the conditions that cause delirium can reduce its risk. In hospitalized people, avoiding or using a low dosage of sedatives, prompt treatment of metabolic disorders and infections, and using reality orientation programs will reduce the risk of delirium in those at high risk.
  • #8 Temporary Confusion & Disorientation (Delirium): Causes & Treatment
    https://www.webmd.com/brain/sudden-confusion-causes
    Sudden confusion, sometimes called delirium or encephalopathy, can be a sign of many health problems. It comes on quickly, within hours or days. Its different from dementia (like Alzheimers disease), which causes slow changes over months or years. […] Many conditions or health problems can cause sudden confusion, and some are more serious than others: They include: Alcohol or drug abuse, Carbon monoxide poisoning, Very low amounts of sodium or calcium in your body, Diabetes (especially low blood sugar or high blood sugar levels), Infections anywhere in the body (including the brain, lungs, and urinary tract). This is especially common for older people. […] Other things can also make you more likely to have sudden confusion, such as if you: Stay in the hospital, especially after an operation, Have a lot of medical problems, Take a lot of medications, or stop taking a daily medication, Are over age 65, Have dementia, Dont eat or drink enough, Are very overtired, Have problems with sight, hearing, or how well you get around.
  • #8 14. CGA in Primary Care Settings: Patients presenting with confusion and delirium | British Geriatrics Society
    https://www.bgs.org.uk/resources/14-cga-in-primary-care-settings-patients-presenting-with-confusion-and-delirium
    The Single Question in Delirium test can pick up 80 per cent of patients with delirium by asking the question: „Do you think [patient’s name] has been more confused lately?” […] NICE guidance recommends use of the Confusion Assessment Method for diagnosis of delirium. […] Once delirium has been identified and diagnosed, a multifactorial assessment and management plan should be undertaken addressing the following features: Treat infection if it’s there, but only if it’s there. […] Address hydration status. […] Address nutritional status. […] Treat constipation. […] Treat pain. […] Identify, and treat urinary retention. […] Encourage mobility. […] Review medications. […] Drug/alcohol withdrawal. […] Assess sleep disturbance. […] Educate and re-orientate. […] The use of large, clearly visible clocks and calendars is recommended, and wherever possible patients should be looked after in a familiar environment by familiar relatives or staff. […] These medications should be avoided if at all possible, and if used, used at the lowest possible dose for as short a time as possible. […] If sedation is used then it should be reviewed and weaned as soon as possible, ideally within 24-48 hours, and certainly no more than seven days.
  • #9 14. CGA in Primary Care Settings: Patients presenting with confusion and delirium | British Geriatrics Society
    https://www.bgs.org.uk/resources/14-cga-in-primary-care-settings-patients-presenting-with-confusion-and-delirium
    The Single Question in Delirium test can pick up 80 per cent of patients with delirium by asking the question: „Do you think [patient’s name] has been more confused lately?” […] NICE guidance recommends use of the Confusion Assessment Method for diagnosis of delirium. […] Once delirium has been identified and diagnosed, a multifactorial assessment and management plan should be undertaken addressing the following features: Treat infection if it’s there, but only if it’s there. […] Address hydration status. […] Address nutritional status. […] Treat constipation. […] Treat pain. […] Identify, and treat urinary retention. […] Encourage mobility. […] Review medications. […] Drug/alcohol withdrawal. […] Assess sleep disturbance. […] Educate and re-orientate. […] The use of large, clearly visible clocks and calendars is recommended, and wherever possible patients should be looked after in a familiar environment by familiar relatives or staff. […] These medications should be avoided if at all possible, and if used, used at the lowest possible dose for as short a time as possible. […] If sedation is used then it should be reviewed and weaned as soon as possible, ideally within 24-48 hours, and certainly no more than seven days.
  • #10 14. CGA in Primary Care Settings: Patients presenting with confusion and delirium | British Geriatrics Society
    https://www.bgs.org.uk/resources/14-cga-in-primary-care-settings-patients-presenting-with-confusion-and-delirium
    The Single Question in Delirium test can pick up 80 per cent of patients with delirium by asking the question: „Do you think [patient’s name] has been more confused lately?” […] NICE guidance recommends use of the Confusion Assessment Method for diagnosis of delirium. […] Once delirium has been identified and diagnosed, a multifactorial assessment and management plan should be undertaken addressing the following features: Treat infection if it’s there, but only if it’s there. […] Address hydration status. […] Address nutritional status. […] Treat constipation. […] Treat pain. […] Identify, and treat urinary retention. […] Encourage mobility. […] Review medications. […] Drug/alcohol withdrawal. […] Assess sleep disturbance. […] Educate and re-orientate. […] The use of large, clearly visible clocks and calendars is recommended, and wherever possible patients should be looked after in a familiar environment by familiar relatives or staff. […] These medications should be avoided if at all possible, and if used, used at the lowest possible dose for as short a time as possible. […] If sedation is used then it should be reviewed and weaned as soon as possible, ideally within 24-48 hours, and certainly no more than seven days.

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