Delirium: Introduction | Definition and Epidemiology | Clinical Features and Course of Delirium | Pathophysiology of Delirium | Assessment Tools for Delirium | Neuropsychological Assessment of Delirium | Risk Factors for Delirium | Medications and Delirium | Diagnosis and Differential Diagnosis of Delirium | Prevention and Management of Delirium | Key Points | References | Suggested Readings
Delirium, defined as an acute and sudden change
in attention and overall cognitive function, is a substantial medical
problem for older persons—and one that may be preventable.
Patients ages 65 years and older account for almost half (49%)
of all days of hospital care, and although delirium is the most
frequent complication affecting this population, it often goes unrecognized.
In fact, delirium affects over 2.5 million patients ages 65 and
older during hospitalization annually (Inouye et al. 1999; U.S. Department of Health and Human Services 2004). Delirium is
a costly condition, leading to increased costs per hospital stay
of at least $2,500 per patient, which translates to $6.9
billion (values in U.S. dollars in 2004) of annual excess Medicare
hospital expenditures directly related to delirium and its complications.
Patients with delirium have a worse prognosis than patients without
delirium and are at an increased risk of developing long-term cognitive
and functional decline (Inouye 2006; Jackson et al. 2004), which in turn leads to additional posthospitalization
treatment costs, such as for institutionalization, rehabilitation
services, and home health care (Inouye 2006). Total
health care costs related to delirium are estimated at $38
billion to $152 billion annually (Leslie et al. 2008).