What is delirium?

Delirium is a common clinical syndrome that is usually caused by a physical illness, general medical condition, drugs, substance intoxication or withdrawal, or other multiple etiologies. Delirium is a serious disturbance with about 30% of older adult patients may experience delirium during hospitalization. Post-surgical patients from about 10 to 50% may experience delirium. 

What are some of the causes of delirium? The causes for delirium are multifactorial and have many contributing factors such as changes in metabolic balance, infection, post-surgery, chronic illness. Patients with delirium are medically sick. Other factors are dementia, previous delirium episodes. Patients with visual or hearing impairment are at higher risk for delirium.  Comorbidities such as Parkinson’s disease, stroke may increase the risk for delirium. Prevalence of delirium in dementia patients may range from about 22 to 89%. Some precipitating factors are polypharmacy or use of the psychoactive drugs. Acute infection, dehydration, immobility with the use of restraint, malnutrition, and usage of bladder catheters increase the risk for delirium.

Delirium is acute and is usually brief from hours to days and is reversible as compared to dementia which is a slower onset, is longer lasting, and is irreversible.

Patients with delirium are usually disoriented to time, date, place, and maybe very confused, stuporous, or may also be hyper-alert, hyperaroused, and maybe agitated.

Patients with delirium may have memory impairment. Some patients may confabulate their stories as well. They present as bizarre, restless, confused, and can be misdiagnosed as having a psychiatric condition. Patients may have difficulty functioning,  distractible, unable to focus have derailment of thoughts. The patient may have perceptual disturbances with hallucinations and May misinterpret and environment. If you think your loved one is having an acute level of change in mood, mentation, and behavior, bring them to a higher level of care.

If your loved one is suffering, from this acute change of behavior, mood, sleep please bring her to her primary care physician. If your loved has depression and insomnia, click on this link for an appointment.