Delirium: current trends in prevention and treatment

Delirium is a disturbance of consciousness, cognition and perception that occurs frequently in medically ill patients. Although it is associated with increased morbidity and mortality, it is often not recognised and treated by physicians. Predisposing factors are believed to have multiplicative effects and include dementia, advanced age and male gender. Recently developed models allow for the estimation of the risk of developing delirium during a hospitalisation, based on predisposing factors and acute additional stressors. Although it has been shown to be efficacious, the prevention of delirium is underutilised. Prevention consists of aggressive management of known risk factors and early detection. Limited data exist to support specific pharmacological interventions for its treatment. In this article, the avail­able published literature regarding the prevention and treatment of delirium is systematically reviewed. (Intern Med J 2004; 34; 115−121)