Skip to main content
SpringerLink
Log in

Delirium

  • Chapter
  • First Online:
Geriatric Psychiatry

  • 245 Accesses

Abstract

Delirium is one of the most serious medical complications experienced by older patients. Emphasis on early recognition, prevention, and management of delirium underlines the need for effective services across multiple settings from community to hospitals and other institutional care settings. At present, the diagnosis of delirium is clinically based. Management strategies for delirium need to be focused on prevention and symptom mitigation. This chapter reviews the etiology, consequences, screening, diagnosis, prevention, and management of delirium in older patients.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed, Text Revision (DSM-5-TR):. American Psychiatric Association; 2022.

    Book  Google Scholar 

  2. World Health Organization. The International Classification of Diseases 11th Revision (ICD-11); 2023. https://icd.who.int/en.

  3. Fong TG, Tulebaev SR, Inouye SK. Delirium in elderly adults: Diagnosis, prevention and treatment. Nat Rev Neurol. 2009;5(4):210–20.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Mattison MLP. Delirium. Ann Intern Med. 2020;173(7):Itc49–64.

    Article  PubMed  Google Scholar 

  5. Inouye SK. Delirium in older persons. N Engl J Med. 2006;354(11):1157–65.

    Article  CAS  PubMed  Google Scholar 

  6. Jin Z, Hu J, Ma D. Postoperative delirium: perioperative assessment, risk reduction, and management. Br J Anaesth. 2020;125(4):492–504.

    Article  PubMed  Google Scholar 

  7. Han JH, Zimmerman EE, Cutler N, Schnelle J, Morandi A, Dittus RS, et al. Delirium in older emergency department patients: Recognition, risk factors, and psychomotor subtypes. Acad Emerg Med Off J Soc Acad Emerg Med. 2009;16(3):193–200.

    Article  Google Scholar 

  8. Siddiqi N, House AO, Holmes JD. Occurrence and outcome of delirium in medical in-patients: A systematic literature review. Age Ageing. 2006;35(4):350–64.

    Article  PubMed  Google Scholar 

  9. Jones SF, Pisani MA. ICU delirium: An update. Curr Opin Crit Care. 2012;18(2):146–51.

    Article  PubMed  Google Scholar 

  10. Spronk PE, Riekerk B, Hofhuis J, Rommes JH. Occurrence of delirium is severely underestimated in the ICU during daily care. Intensive Care Med. 2009;35(7):1276–80.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Lawlor PG, Gagnon B, Mancini IL, Pereira JL, Hanson J, Suarez-Almazor ME, Bruera ED. Occurrence, causes, and outcome of delirium in patients with advanced cancer: A prospective study. Arch Intern Med. 2000;160(6):786–94.

    Article  CAS  PubMed  Google Scholar 

  12. Recchia A, Rizzi B, Favero A, Nobili A, Pasina L. Prevalence of delirium in end-of-life palliative care patients: An observational study. Med Princ Pract. 2022;31(2):118–24.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet. 2014;383(9920):911–22.

    Article  PubMed  Google Scholar 

  14. Ouimet S, Kavanagh BP, Gottfried SB, Skrobik Y. Incidence, risk factors and consequences of ICU delirium. Intensive Care Med. 2007;33(1):66–73.

    Article  PubMed  Google Scholar 

  15. Ahmed S, Leurent B, Sampson EL. Risk factors for incident delirium among older people in acute hospital medical units: A systematic review and meta-analysis. Age Ageing. 2014;43(3):326–33.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Laurila JV, Laakkonen ML, Tilvis RS, Pitkala KH. Predisposing and precipitating factors for delirium in a frail geriatric population. J Psychosom Res. 2008;65(3):249–54.

    Article  PubMed  Google Scholar 

  17. Maldonado JR. Delirium in the acute care setting: characteristics, diagnosis and treatment. Crit Care Clin. 2008;24(4):657–722, vii

    Article  CAS  PubMed  Google Scholar 

  18. Maldonado JR. Delirium pathophysiology: An updated hypothesis of the etiology of acute brain failure. Int J Geriatr Psychiatry. 2018;33(11):1428–57.

    Article  PubMed  Google Scholar 

  19. Hshieh TT, Inouye SK, Oh ES. Delirium in the elderly. Psychiatr Clin North Am. 2018;41(1):1–17.

    Article  PubMed  Google Scholar 

  20. Davis DH, Muniz Terrera G, Keage H, Rahkonen T, Oinas M, Matthews FE, et al. Delirium is a strong risk factor for dementia in the oldest-old: A population-based cohort study. Brain. 2012;135(Pt 9):2809–16.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Meagher DJ, Trzepacz PT. Motoric subtypes of delirium. Semin Clin Neuropsychiatry. 2000;5(2):75–85.

    CAS  PubMed  Google Scholar 

  22. Marcantonio E, Ta T, Duthie E, Resnick NM. Delirium severity and psychomotor types: their relationship with outcomes after hip fracture repair. J Am Geriatr Soc. 2002;50(5):850–7.

    Article  PubMed  Google Scholar 

  23. Rabinowitz T. Delirium: an important (but often unrecognized) clinical syndrome. Curr Psychiatry Rep. 2002;4(3):202–8.

    Article  PubMed  Google Scholar 

  24. Meagher D, O’Regan N, Ryan D, Connolly W, Boland E, O’Caoimhe R, et al. Frequency of delirium and subsyndromal delirium in an adult acute hospital population. Br J Psychiatry. 2014;205(6):478–85.

    Article  CAS  PubMed  Google Scholar 

  25. Sepulveda E, Leonard M, Franco JG, Adamis D, McCarthy G, Dunne C, et al. Subsyndromal delirium compared with delirium, dementia, and subjects without delirium or dementia in elderly general hospital admissions and nursing home residents. Alzheimers Dement (Amst). 2017;7:1–10.

    Article  PubMed  Google Scholar 

  26. Meagher D, Adamis D, Trzepacz P, Leonard M. Features of subsyndromal and persistent delirium. Br J Psychiatry. 2012;200(1):37–44.

    Article  PubMed  Google Scholar 

  27. Cole MG, McCusker J, Voyer P, Monette J, Champoux N, Ciampi A, et al. Subsyndromal delirium in older long-term care residents: Incidence, risk factors, and outcomes. J Am Geriatr Soc. 2011;59(10):1829–36.

    Article  PubMed  Google Scholar 

  28. Meagher DJ, Leonard M, Donnelly S, Conroy M, Adamis D, Trzepacz PT. A longitudinal study of motor subtypes in delirium: Relationship with other phenomenology, etiology, medication exposure and prognosis. J Psychosom Res. 2011;71(6):395–403.

    Article  PubMed  Google Scholar 

  29. Robinson TN, Raeburn CD, Tran ZV, Brenner LA, Moss M. Motor subtypes of postoperative delirium in older adults. Arch Surg. 2011;146(3):295–300.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Trzepacz PT, Franco JG, Meagher DJ, Lee Y, Kim JL, Kishi Y, et al. Delirium phenotype by age and sex in a pooled data set of adult patients. J Neuropsychiatry Clin Neurosci. 2018;30(4):294–301.

    Article  PubMed  Google Scholar 

  31. Albrecht JS, Marcantonio ER, Roffey DM, Orwig D, Magaziner J, Terrin M, et al. Stability of postoperative delirium psychomotor subtypes in individuals with hip fracture. J Am Geriatr Soc. 2015;63(5):970–6.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Meagher DJ, Moran M, Raju B, Gibbons D, Donnelly S, Saunders J, Trzepacz PT. Motor symptoms in 100 patients with delirium versus control subjects: Comparison of subtyping methods. Psychosomatics. 2008;49(4):300–8.

    Article  PubMed  Google Scholar 

  33. Ross CA, Peyser CE, Shapiro I, Folstein MF. Delirium: Phenomenologic and etiologic subtypes. Int Psychogeriatr. 1991;3(2):135–47.

    Article  CAS  PubMed  Google Scholar 

  34. Leonard M, Donnelly S, Conroy M, Trzepacz P, Meagher DJ. Phenomenological and neuropsychological profile across motor variants of delirium in a palliative-care unit. J Neuropsychiatry Clin Neurosci. 2011;23(2):180–8.

    Article  PubMed  Google Scholar 

  35. Johnson MH. Assessing confused patients. J Neurol Neurosurg Psychiatry. 2001;71 Suppl 1(Suppl 1):i7–12.

    CAS  PubMed  Google Scholar 

  36. Fong TG, Inouye SK. The inter-relationship between delirium and dementia: The importance of delirium prevention. Nat Rev Neurol. 2022;18(10):579–96.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Meagher DJ, Moran M, Raju B, Gibbons D, Donnelly S, Saunders J, Trzepacz PT. Phenomenology of delirium. Assessment of 100 adult cases using standardised measures. Br J Psychiatry. 2007;190:135–41.

    Article  PubMed  Google Scholar 

  38. Krewulak KD, Stelfox HT, Leigh JP, Ely EW, Fiest KM. Incidence and prevalence of delirium subtypes in an adult ICU: A systematic review and Meta-analysis. Crit Care Med. 2018;46(12):2029–35.

    Article  PubMed  Google Scholar 

  39. Charlton BG, Kavanau JL. Delirium and psychotic symptoms—An integrative model. Med Hypotheses. 2002;58(1):24–7.

    Article  CAS  PubMed  Google Scholar 

  40. Mittal D, Majithia D, Kennedy R, Rhudy J. Differences in characteristics and outcome of delirium as based on referral patterns. Psychosomatics. 2006;47(5):367–75.

    Article  PubMed  Google Scholar 

  41. Canadian Coalition for Seniors’ Mental Health. National guidelines for seniors’ mental health: The assessment and treatment of delirium Toronto. Canada: Canadian Government Printing Office; 2006. http://ccsmh.ca/wp-content/uploads/2016/03/NatlGuideline_Delirium.pdf

    Google Scholar 

  42. Cook IA. Guideline watch: practice guideline for the treatment of patients with delirium. Arlington, VA: American Psychiatric Association; 2004. http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/delirium-watch.pdf

    Google Scholar 

  43. Leentjens AF, Diefenbacher A. A survey of delirium guidelines in Europe. J Psychosom Res. 2006;61(1):123–8.

    Article  PubMed  Google Scholar 

  44. Tropea J, Slee JA, Brand CA, Gray L, Snell T. Clinical practice guidelines for the management of delirium in older people in Australia. Australas J Ageing. 2008;27(3):150–6.

    Article  PubMed  Google Scholar 

  45. Adamis D, Macdonald A, McCarthy G, Morandi A, Bellelli G, Meagher D. Towards understanding the nature and need of delirium guidelines across nations and cultures. Aging Clin Exp Res. 2022;34(3):633–42.

    Article  PubMed  Google Scholar 

  46. Pan Y, Jiang Z, Yuan C, Wang L, Zhang J, Zhou J, et al. Influence of physical restraint on delirium of adult patients in ICU: A nested case-control study. J Clin Nurs. 2018;27(9–10):1950–7.

    Article  PubMed  Google Scholar 

  47. Gugger JJ, Wagner ML. Rapid eye movement sleep behavior disorder. Ann Pharmacother. 2007;41(11):1833–41.

    Article  PubMed  Google Scholar 

  48. Chédru F, Geschwind N. Writing disturbances in acute confusional states. Neuropsychologia. 1972;10(3):343–53.

    Article  PubMed  Google Scholar 

  49. Beglinger LJ, Mills JA, Vik SM, Duff K, Denburg NL, Weckmann MT, et al. The neuropsychological course of acute delirium in adult hematopoietic stem cell transplantation patients. Arch Clin Neuropsychol. 2011;26(2):98–109.

    Article  PubMed  Google Scholar 

  50. Goldberg TE, Chen C, Wang Y, Jung E, Swanson A, Ing C, et al. Association of delirium with long-term cognitive decline: A meta-analysis. JAMA Neurol. 2020;77(11):1373–81.

    Article  PubMed  Google Scholar 

  51. Guu TW, Aarsland D, Ffytche D. Light, sleep-wake rhythm, and behavioural and psychological symptoms of dementia in care home patients: Revisiting the sundowning syndrome. Int J Geriatr Psychiatry. 2022;37(5)

    Google Scholar 

  52. Gnanasekaran G. "Sundowning" as a biological phenomenon: current understandings and future directions: an update. Aging Clin Exp Res. 2016;28(3):383–92.

    Article  PubMed  Google Scholar 

  53. Adamis D, Sharma N, Whelan PJ, Macdonald AJ. Delirium scales: A review of current evidence. Aging Ment Health. 2010;14(5):543–55.

    Article  PubMed  Google Scholar 

  54. Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: The confusion assessment method. A new method for detection of delirium. Ann Intern Med. 1990;113(12):941–8.

    Article  CAS  PubMed  Google Scholar 

  55. Fick DM, Agostini JV, Inouye SK. Delirium superimposed on dementia: a systematic review. J Am Geriatr Soc. 2002;50(10):1723–32.

    Article  PubMed  Google Scholar 

  56. Morandi A, Davis D, Fick DM, Turco R, Boustani M, Lucchi E, et al. Delirium superimposed on dementia strongly predicts worse outcomes in older rehabilitation inpatients. J Am Med Dir Assoc. 2014;15(5):349–54.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Kat MG, Vreeswijk R, de Jonghe JF, van der Ploeg T, van Gool WA, Eikelenboom P, Kalisvaart KJ. Long-term cognitive outcome of delirium in elderly hip surgery patients. A prospective matched controlled study over two and a half years. Dement Geriatr Cogn Disord. 2008;26(1):1–8.

    Article  PubMed  Google Scholar 

  58. Fong TG, Jones RN, Shi P, Marcantonio ER, Yap L, Rudolph JL, et al. Delirium accelerates cognitive decline in Alzheimer disease. Neurology. 2009;72(18):1570–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Wacker P, Nunes PV, Cabrita H, Forlenza OV. Post-operative delirium is associated with poor cognitive outcome and dementia. Dement Geriatr Cogn Disord. 2006;21(4):221–7.

    Article  PubMed  Google Scholar 

  60. Meagher DJ, Leonard M, Donnelly S, Conroy M, Saunders J, Trzepacz PT. A comparison of neuropsychiatric and cognitive profiles in delirium, dementia, comorbid delirium-dementia and cognitively intact controls. J Neurol Neurosurg Psychiatry. 2010;81(8):876–81.

    Article  PubMed  Google Scholar 

  61. Dubin WR, Weiss KJ, Zeccardi JA. Organic brain syndrome. The psychiatric imposter. JAMA. 1983;249(1):60–2.

    Article  CAS  PubMed  Google Scholar 

  62. Dupont S. Non convulsive status epilepticus in the elderly. Geriatr Psychol Neuropsychiatr Vieil. 2019;17(S1):25–30.

    PubMed  Google Scholar 

  63. Habeych ME, Falcone T, Dagar A, Ford L, Castilla-Puentes R. Dementia, subtype of seizures, and the risk of new onset seizures: A cohort study. J Alzheimers Dis. 2021;81(3):973–80.

    Article  CAS  PubMed  Google Scholar 

  64. Balogun SA, Philbrick JT. Delirium, a symptom of UTI in the elderly: Fact or fable? A systematic review. Canad Geriatr J. 2014;17(1):22–6.

    Article  Google Scholar 

  65. Jacobson S, Jerrier H. EEG in delirium. Semin Clin Neuropsychiatry. 2000;5(2):86–92.

    CAS  PubMed  Google Scholar 

  66. Vijayakrishnan R, Ramasubramanian A, Dhand S. Utility of head CT scan for acute inpatient delirium. Hosp Top. 2015;93(1):9–12.

    Article  PubMed  Google Scholar 

  67. Yen FS, Chang SH, Wei JC, Shih YH, Hwu CM. Respiratory outcomes of insulin use in patients with COPD: A Nationwide population-based cohort study. Pharmaceuticals (Basel). 2023;16(5)

    Google Scholar 

  68. Milisen K, Lemiengre J, Braes T, Foreman MD. Multicomponent intervention strategies for managing delirium in hospitalized older people: Systematic review. J Adv Nurs. 2005;52(1):79–90.

    Article  PubMed  Google Scholar 

  69. Yue J, Tabloski P, Dowal SL, Puelle MR, Nandan R, Inouye SK. NICE to HELP: Operationalizing National Institute for health and clinical excellence guidelines to improve clinical practice. J Am Geriatr Soc. 2014;62(4):754–61.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Marcantonio ER. Delirium in hospitalized older adults. N Engl J Med. 2017;377(15):1456–66.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Kosar CM, Thomas KS, Inouye SK, Mor V. Delirium during postacute nursing home admission and risk for adverse outcomes. J Am Geriatr Soc. 2017;65(7):1470–5.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Gong KD, Lu R, Bergamaschi TS, Sanyal A, Guo J, Kim HB, et al. Predicting intensive care delirium with machine learning: Model development and external validation. Anesthesiology. 2023;138(3):299–311.

    Article  CAS  PubMed  Google Scholar 

  73. Liu Y, Shen W, Tian Z. Using machine learning algorithms to predict high-risk factors for postoperative delirium in elderly patients. Clin Interv Aging. 2023;18:157–68.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  74. Siddiqi N, Harrison JK, Clegg A, Teale EA, Young J, Taylor J, Simpkins SA. Interventions for preventing delirium in hospitalised non-ICU patients. Cochrane Database Syst Rev. 2016;(3):Cd005563.

    Google Scholar 

  75. Deschodt M, Braes T, Flamaing J, Detroyer E, Broos P, Haentjens P, et al. Preventing delirium in older adults with recent hip fracture through multidisciplinary geriatric consultation. J Am Geriatr Soc. 2012;60(4):733–9.

    Article  PubMed  Google Scholar 

  76. American Geriatrics Society Expert Panel on Postoperative Delirium in Older Adults. American Geriatrics Society abstracted clinical practice guideline for postoperative delirium in older adults. J Am Geriatr Soc. 2015;63(1):142–50.

    Article  Google Scholar 

  77. Martinez F, Tobar C, Hill N. Preventing delirium: should non-pharmacological, multicomponent interventions be used? A systematic review and meta-analysis of the literature. Age Ageing. 2015;44(2):196–204.

    Article  PubMed  Google Scholar 

  78. Monaghan C, Martin G, Kerr J, Peters ML, Versloot J. Effectiveness of Interprofessional consultation-based interventions for delirium: A scoping review. J Appl Gerontol. 2022;41(3):881–91.

    Article  PubMed  Google Scholar 

  79. Hshieh TT, Yang T, Gartaganis SL, Yue J, Inouye SK. Hospital elder life program: systematic review and meta-analysis of effectiveness. Am J Geriatr Psychiatry. 2018;26(10):1015–33.

    Article  PubMed  PubMed Central  Google Scholar 

  80. Hirsch CH, Maharaj M, Bourgeois JA. The chief adverse effects of medications. In: Hategan A, Bourgeois JA, Hirsch CH, editors. On-call geriatric psychiatry: Handbook of principles and practice. Switzerland: Springer; 2016. p. 161–83.

    Chapter  Google Scholar 

  81. American Geriatrics Society. American Geriatrics Society 2019 updated AGS beers criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2019;67(4):674–94.

    Article  Google Scholar 

  82. Davis MP, Srivastava M. Demographics, assessment and management of pain in the elderly. Drugs Aging. 2003;20(1):23–57.

    Article  CAS  PubMed  Google Scholar 

  83. Hanania M, Kitain E. Melatonin for treatment and prevention of postoperative delirium. Anesth Analg. 2002;94(2):338–9. table of contents

    Article  PubMed  Google Scholar 

  84. Maldonado JR. Neuropathogenesis of delirium: Review of current etiologic theories and common pathways. Am J Geriatr Psychiatry. 2013;21(12):1190–222.

    Article  PubMed  Google Scholar 

  85. Fok MC, Sepehry AA, Frisch L, Sztramko R, Borger van der Burg BL, Vochteloo AJ, Chan P. Do antipsychotics prevent postoperative delirium? A systematic review and meta-analysis. Int J Geriatr Psychiatry. 2015;30(4):333–44.

    Article  PubMed  Google Scholar 

  86. Kalisvaart KJ, de Jonghe JF, Bogaards MJ, Vreeswijk R, Egberts TC, Burger BJ, et al. Haloperidol prophylaxis for elderly hip-surgery patients at risk for delirium: A randomized placebo-controlled study. J Am Geriatr Soc. 2005;53(10):1658–66.

    Article  PubMed  Google Scholar 

  87. Neufeld KJ, Yue J, Robinson TN, Inouye SK, Needham DM. Antipsychotic medication for prevention and treatment of delirium in hospitalized adults: A systematic review and Meta-analysis. J Am Geriatr Soc. 2016;64(4):705–14.

    Article  PubMed  PubMed Central  Google Scholar 

  88. Shen YZ, Peng K, Zhang J, Meng XW, Ji FH. Effects of haloperidol on delirium in adult patients: A systematic review and Meta-analysis. Med Princ Pract. 2018;27(3):250–9.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Rivière J, van der Mast RC, Vandenberghe J, Van Den Eede F. Efficacy and tolerability of atypical antipsychotics in the treatment of delirium: A systematic review of the literature. Psychosomatics. 2019;60(1):18–26.

    Article  PubMed  Google Scholar 

  90. Korenoski A, Li A, Kane-Gill SL, Seybert AL, Smithburger PL. Pharmacologic management of delirium in the ICU: A review of the literature. J Intensive Care Med. 2020;35(2):107–17.

    Article  PubMed  Google Scholar 

  91. Djaiani G, Silverton N, Fedorko L, Carroll J, Styra R, Rao V, Katznelson R. Dexmedetomidine versus propofol sedation reduces delirium after cardiac surgery: A randomized controlled trial. Anesthesiology. 2016;124(2):362–8.

    Article  CAS  PubMed  Google Scholar 

  92. Maldonado JR, Wysong A, van der Starre PJ, Block T, Miller C, Reitz BA. Dexmedetomidine and the reduction of postoperative delirium after cardiac surgery. Psychosomatics. 2009;50(3):206–17.

    Article  CAS  PubMed  Google Scholar 

  93. Shin HJ, Woo Nam S, Kim H, Yim S, Han SH, Hwang JW, et al. Postoperative delirium after dexmedetomidine versus propofol sedation in healthy older adults undergoing orthopedic lower limb surgery with spinal anesthesia: A randomized controlled trial. Anesthesiology. 2023;138(2):164–71.

    Article  CAS  PubMed  Google Scholar 

  94. Short J. Use of dexmedetomidine for primary sedation in a general intensive care unit. Crit Care Nurse. 2010;30(1):29–38; quiz 9

    Article  PubMed  Google Scholar 

  95. Burry L, Hutton B, Williamson DR, Mehta S, Adhikari NK, Cheng W, et al. Pharmacological interventions for the treatment of delirium in critically ill adults. Cochrane Database Syst Rev. 2019;9(9):Cd011749.

    PubMed  Google Scholar 

  96. Flükiger J, Hollinger A, Speich B, Meier V, Tontsch J, Zehnder T, Siegemund M. Dexmedetomidine in prevention and treatment of postoperative and intensive care unit delirium: A systematic review and meta-analysis. Ann Intensive Care. 2018;8(1):92.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Tampi RR, Tampi DJ, Ghori AK. Acetylcholinesterase inhibitors for delirium in older adults. Am J Alzheimers Dis Other Dement. 2016;31(4):305–10.

    Article  Google Scholar 

  98. Youn YC, Shin HW, Choi BS, Kim S, Lee JY, Ha YC. Rivastigmine patch reduces the incidence of postoperative delirium in older patients with cognitive impairment. Int J Geriatr Psychiatry. 2017;32(10):1079–84.

    Article  PubMed  Google Scholar 

  99. de Jonghe A, van Munster BC, Goslings JC, Kloen P, van Rees C, Wolvius R, et al. Effect of melatonin on incidence of delirium among patients with hip fracture: A multicentre, double-blind randomized controlled trial. CMAJ. 2014;186(14):E547–56.

    Article  PubMed  PubMed Central  Google Scholar 

  100. Al-Aama T, Brymer C, Gutmanis I, Woolmore-Goodwin SM, Esbaugh J, Dasgupta M. Melatonin decreases delirium in elderly patients: A randomized, placebo-controlled trial. Int J Geriatr Psychiatry. 2011;26(7):687–94.

    Article  PubMed  Google Scholar 

  101. Crowley KE, Urben L, Hacobian G, Geiger KL. Valproic acid for the management of agitation and delirium in the intensive care setting: A retrospective analysis. Clin Ther. 2020;42(4):e65–73.

    Article  CAS  PubMed  Google Scholar 

  102. Chen CC, Saczynski J, Inouye SK. The modified hospital elder life program: Adapting a complex intervention for feasibility and scalability in a surgical setting. J Gerontol Nurs. 2014;40(5):16–22.

    Article  PubMed  Google Scholar 

  103. Buter TC, van den Hout A, Matthews FE, Larsen JP, Brayne C, Aarsland D. Dementia and survival in Parkinson disease: A 12-year population study. Neurology. 2008;70(13):1017–22.

    Article  CAS  PubMed  Google Scholar 

  104. Hely MA, Reid WG, Adena MA, Halliday GM, Morris JG. The Sydney multicenter study of Parkinson’s disease: The inevitability of dementia at 20 years. Mov Disord. 2008;23(6):837–44.

    Article  PubMed  Google Scholar 

  105. Seitz DP, Gill SS. Neuroleptic malignant syndrome complicating antipsychotic treatment of delirium or agitation in medical and surgical patients: Case reports and a review of the literature. Psychosomatics. 2009;50(1):8–15.

    Article  CAS  PubMed  Google Scholar 

  106. Brown AS, Rosen J. Lithium-induced delirium with therapeutic serum lithium levels: A case report. J Geriatr Psychiatry Neurol. 1992;5(1):53–5.

    Article  CAS  PubMed  Google Scholar 

  107. Alexopoulos GS, Streim J, Carpenter D, Docherty JP. Using antipsychotic agents in older patients. J Clin Psychiatry. 2004;65(Suppl 2):5–99; discussion 100–2; quiz 3–4

    PubMed  Google Scholar 

  108. Granja C, Gomes E, Amaro A, Ribeiro O, Jones C, Carneiro A, Costa-Pereira A. Understanding posttraumatic stress disorder-related symptoms after critical care: The early illness amnesia hypothesis. Crit Care Med. 2008;36(10):2801–9.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Geriatric Psychiatry, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada

    Ana Hategan

  2. Department of Psychiatry and Behavioral Sciences, University of California, Davis Medical Center, Sacramento, CA, USA

    James A. Bourgeois

  3. Division of General Medicine, University of California, Davis Medical Center, Sacramento, CA, USA

    Calvin H. Hirsch

  4. Kaiser Permanente South Sacramento Medical Center (Ret.), Sacramento, CA, USA

    Deborah Francis

Authors
  1. Ana Hategan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Calvin H. Hirsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. James A. Bourgeois
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Deborah Francis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ana Hategan .

Editor information

Editors and Affiliations

  1. Division of Geriatric Psychiatry, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada

    Ana Hategan

  2. Department of Psychiatry and Behavioral Sciences, University of California, Davis Medical Center, Sacramento, CA, USA

    James A. Bourgeois

  3. Division of General Medicine, University of California, Davis Medical Center, Sacramento, CA, USA

    Calvin H. Hirsch

  4. Department of Psychiatry and Behavioral Sciences, University of California, Davis Medical Center, Sacramento, CA, USA

    Caroline Giroux

Rights and permissions

Reprints and permissions

Copyright information

© 2024 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Hategan, A., Hirsch, C.H., Bourgeois, J.A., Francis, D. (2024). Delirium. In: Hategan, A., Bourgeois, J.A., Hirsch, C.H., Giroux, C. (eds) Geriatric Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-031-47802-4_17

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-47802-4_17

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-47801-7

  • Online ISBN: 978-3-031-47802-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation