Delirium

Delirium is a sudden and severe disturbance in mental abilities that results in confusion, reduced awareness of the environment, and impaired attention. It usually develops over a short period of time and tends to fluctuate throughout the day. Delirium is most commonly seen in older adults, particularly during hospitalization or serious illness, and is considered a medical emergency requiring prompt evaluation.

Symptoms

Symptoms of delirium can vary in type and severity and often change rapidly:

• Sudden confusion or disorientation

• Difficulty focusing or maintaining attention

• Altered level of consciousness

• Memory problems

• Disorganized thinking or speech

• Hallucinations or delusions

• Sleep–wake cycle disturbances

• Agitation or restlessness, or alternatively, lethargy

Causes

Delirium is usually caused by an underlying medical condition or multiple contributing factors:

• Infections such as urinary tract or lung infections

• Dehydration or electrolyte imbalances

• Medication side effects or withdrawal

• Surgery or anesthesia

• Severe illness or organ failure

• Alcohol or drug intoxication or withdrawal

• Pain or untreated medical conditions

Risk Factors

Certain individuals are more vulnerable to developing delirium:

• Older age

• Pre-existing dementia or cognitive impairment

• Hospitalization or intensive care admission

• Sensory impairment such as vision or hearing loss

• Multiple chronic medical conditions

• Use of multiple medications

Complications

Delirium can lead to serious short- and long-term complications:

• Increased risk of falls and injuries

• Prolonged hospital stay

• Functional decline

• Long-term cognitive impairment

• Increased risk of institutionalization

• Higher mortality rates

Prevention

Preventive strategies focus on addressing risk factors and maintaining cognitive stability:

• Ensuring adequate hydration and nutrition

• Managing pain effectively

• Reviewing medications regularly

• Promoting regular sleep–wake cycles

• Providing orientation cues such as clocks and calendars

• Encouraging mobility and early rehabilitation

• Prompt treatment of infections or medical conditions