Somatic causes of delirium in elderly patients
Journal Title: Postępy Nauk Medycznych - Year 2011, Vol 24, Issue 8
Abstract
Delirium is defined as transient brain dysfunction characterized by altered level of consciousness, impaired attention and cognitive functions as well as fluctuating course. Etiology of delirium is multifactorial, clinical picture diverse and pathophysiology includes unstable brain homeostasis and cholinergic deficit. Delirium is a frequent disorder among elderly patients hospitalized due to somatic disorders and diseases requiring surgery, especially orthopedic treatment. Besides age, cognitive impairment in dementia is an important risk factor for development of delirium, but it is worth to notice that delirium overlapping with dementia is often caused by somatic disorders triggering altered mental status in vulnerable individuals. Delirium is often underdiagnosed, especially in cases with low severity and hypoactive presentation. Unrecognized and untreated delirium results in increased morbidity and mortality, prolonged hospital stay and augmented cost of treatment as well as provides risk for further life-threatening complications. The most frequent somatic causes of delirium include dehydration, electrolyte imbalance, particularly hyponatremia, disease states associated with hypoxia and renal failure. Drug adverse events and interactions play a major role in development of delirium, especially in individuals with multiple diseases and malnutrition. Laboratory tests and imaging assessing functional status of organ systems are useful in differential diagnosis of delirium and facilitate recognition of disease states requiring immediate treatment. Medical staff of conservative as well as surgical departments should be educated to diagnose and monitor delirium. Introduction of geriatric care standards including prevention and treatment of delirium could improve the quality of care for the elderly patients.
Authors and Affiliations
Katarzyna Broczek
Keywords
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