This is a general approach to investigating delirium in elderly people, including diagnosis, investigations, management options (including possible hospital admission) and follow up issues.
- Acute confusion or delirium in elderly people may indicate a serious underlying illness and afterwards may predict increased morbidity and mortality.
- Patients aged over 80 years and with dementia, multiple medical problems and multiple medications are at particular risk of delirium.
- An underlying cause or causes should be sought.
- Management includes treatment of the underlying illness, antipsychotics when required and environmental support.
- Admission to hospital is required when the causative illness requires inpatient management or patients are unable to be managed in their own environment.
- Referral to a geriatrician may be indicated when confusion fails to improve over two to three weeks and when underlying dementia may be suspected.