Delirium

Delirium in aging adults correlates strongly with poor outcomes and inappropriate interventions (Bellelli et al. Front Aging Neurosci 13:1–13, 2021). Unfortunately, it is also often missed (Hercus and Hudaib BMC Health Serv Res 20:1–7, 2020). Rates of misdiagnosis have been estimated as high as 64% (de la Cruz et al. Supportive Care Cancer 23(8): 2427–2433, 2015). This chapter offers an overview of delirium to encourage its early identification, its non-pharmacological management, and, where needed, age-adjusted pharmacotherapy. Accurate, timely diagnosis, and appropriate treatment of delirium has implications for the health delivery system at large. The fiscal impact of delirium is enormous; annual healthcare costs attributed to delirium in the United States are estimated at $164 billion due in part to longer hospitalizations, increased readmission rates, increased morbidity, functional decline, and increased rates of institutionalization and mortality (Maldonado, Crit Care Clin, 33:461–519, 2017).