Delirium, dementia and senility

Abstract

Delirium is a neuropsychiatric syndrome characterized by sudden onset and global effects on degrees of consciousness, attention and cognition. It is now widely recognized that delirium is associated with high morbidity and mortality. Increasing age appears the strongest risk factor for delirium (Table 1). It affects up to 40% of all medically ill older adults. Delirium subsequent to surgical procedures, particularly those involving major fractures, cardiovascular grafting or organ transplantation is unpredictable, ranging 9–87% with an average of 40%, depending on the age of the patient, type of intervention and pre-existing vascular disease risks or infections (Cerejeira and Mukaetova-Ladinska, 2011). The presence of delirium complicates outcomes in the majority of ill patients, as demonstrated by longer hospital admission, and impact on daily performance, frequently leading to costly institutional care. In all these situations, it is necessary to ensure that delirium is consistently and correctly diagnosed. Being well qualified to make the diagnosis—as psychiatrist, neurologist or geriatrician—is an important consideration when reporting on the nature or consequences of delirium in any particular study.