Delirium

Delirium is defined as an acute impairment in attention with reduced awareness of the environment. Delirium in the geriatric population is common, particularly in the hospital setting, but is frequently underrecognized. Risk factors for delirium include advanced age, a history of dementia, use of deliriogenic medications, alcoholism, severe illness, blood transfusions in surgical patients, and environmental disruptions in sleep hygiene. Validated delirium assessment tools can be performed at the bedside to recognize and address delirium. Research does not support the use of any single medication class to treat delirium. Hence, the management of delirium is largely non-pharmacologic and consists of a multimodal approach aimed at redirection and reorientation of the patient, early mobility, and optimizing the hospital environment to preserve circadian rhythms.