Delirium in elderly people

Review

关键词: CONFUSION ASSESSMENT METHOD;    CRITICALLY-ILL PATIENTS;    POSTOPERATIVE DELIRIUM;    HIP-FRACTURE;    LIFE-PROGRAM;    FUNCTIONAL DECLINE;    RISK-FACTORS;    SYSTEMIC INFLAMMATION;    EMERGENCY-DEPARTMENT;    CEREBROSPINAL-FLUID;   

DOI  :  10.1016/S0140-6736(13)60688-1

来源: SCIE

【 摘 要 】

Delirium is an acute disorder of attention and cognition in elderly people (ie, those aged 65 years or older) that is common, serious, costly, under-recognised, and often fatal. A formal cognitive assessment and history of acute onset of symptoms are necessary for diagnosis. In view of the complex multifactorial causes of delirium, multicomponent non-pharmacological risk factor approaches are the most effective strategy for prevention. No convincing evidence shows that pharmacological prevention or treatment is effective. Drug reduction for sedation and analgesia and non-pharmacological approaches are recommended. Delirium offers opportunities to elucidate brain pathophysiology-it serves both as a marker of brain vulnerability with decreased reserve and as a potential mechanism for permanent cognitive damage. As a potent indicator of patients' safety, delirium provides a target for system-wide process improvements. Public health priorities include improvements in coding, reimbursement from insurers, and research funding, and widespread education for clinicians and the public about the importance of delirium.

【 授权许可】

Free