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Delirium, which is usually a sign of a newly developed disorder, affects about one third of hospitalized people aged 70 or older. Delirium may be distinguished from psychosis , in which consciousness and cognition may not be impaired (however, there may be overlap, as some acute psychosis, especially with mania, is capable of producing delirium states). Factors associated with a higher risk of delirium include advanced or very young age, pre-existing brain trauma (eg, dementia, cerebrovascular disease, tumor, etc.), alcohol dependence, diabetes mellitus, cancer, sensory impairment (eg, blindness or poor hearing), malnutrition, and a history of delirium. Delirium is common in the United States. Delirium is present in 10-22% of elderly patients at the time of admission, with an additional 10-30% of cases developing after admission. Delirium has been found in 40% of patients admitted to intensive care units. Medications may be required to control aggressive or agitated behaviors or behaviors that are dangerous to the person or to others. Antipsychotics are the treatment of choice for distressing symptoms although ones with minimal anticholinergic activity, such as haloperidol or risperidone are preferable.
Causes of Delirium
Common Causes and Risk factors of Delirium
- DSM-IV classification of delirium.
- Metabolic abnormalities.
- Infections.
- Structural lesions of the brain.
- Alcohol.
- Pneumonia.
- Urinary tract infections.
Signs and Symptoms of Delirium
Common Sign and Symptoms of Delirium
- Anxiety.
- Depression.
- Euphoria.
- Irritability.
- Incorrect attribution.
- Altered level of consciousness or awareness.
- Altered sleep patterns, drowsiness.
Treatment for Delirium
Common Treatment for Delirium
- Antipsychotic drugs or sedatives, such as haloperidol or risperidone are preferable.
- Behavior modification may be helpful for some people to control unacceptable or dangerous behaviors.
- Benzodiazepines are usually avoided in alcohol withdrawal.
- Environmental interventions are very useful in treating the symptoms of delirium.
- Reorientation techniques or memory cues such as a calendar, clocks, and family photos may be helpful.
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