- Section 1 The Subject Matter of and Approach to Psychiatry
- 1.3 Psychiatry as a worldwide public health problem
- 1.4 The history of psychiatry as a medical specialty
- 1.5 Ethics and values
- 1.6 The psychiatrist as a manager
- 1.7 Descriptive phenomenology
- 1.8 Assessment
- 1.9 Diagnosis and classification
- 1.10 From science to practice
- Section 2 The Scientific Basis of Psychiatric Aetiology
- 2.3 The contribution of neurosciences
- 2.4 The contribution of genetics
- 2.5 The contribution of psychological science
- 2.6 The contribution of social sciences
- 2.7 The contribution of epidemiology to psychiatric aetiology
- Section 3 Psychodynamic Contributions to Psychiatry
- Section 4 Clinical Syndromes of Adult Psychiatry
- 4.4 Persistent delusional symptoms and disorders
- 4.5 Mood disorders
- 4.6 Stress-related and adjustment disorders
- 4.7 Anxiety disorders
- Section 5 Psychiatry and Medicine
- Section 6 Treatment Methods in Psychiatry
- 6.2 Somatic treatments
- Section 7 Social Psychiatry and Service Provision
- Section 8 The Psychiatry of Old Age
- 8.1 The biology of ageing
- 8.2 Sociology of normal ageing
- 8.3 The ageing population and the epidemiology of mental disorders among the elderly
- 8.4 Assessment of mental disorder in older patients
- 8.5 Special features of clinical syndromes in the elderly
- 8.5.1 Delirium in the elderly
- 8.5.1.1 Mild cognitive impairment
- 8.5.2 Substance use disorders in older people
- 8.5.3 Schizophrenia and paranoid disorders in late life
- 8.5.4 Mood disorders in the elderly
- 8.5.5 Stress-related, anxiety, and obsessional disorders in elderly people
- 8.5.6 Personality disorders in the elderly
- 8.5.7 Suicide and deliberate self-harm in elderly people
- 8.5.8 Sex in old age
- 8.6 Special features of psychiatric treatment for the elderly
- 8.7 The planning and organization of services for older adults
- Section 9 Child and Adolescent Psychiatry
Delirium in the elderly
- Chapter:
- Delirium in the elderly
- Author(s):
James Lindesay
- DOI:
- 10.1093/med/9780199696758.003.0197
Although delirium occurs at all ages, it is most frequently encountered in late life. This is because delirium is the result of an interaction between individual vulnerability factors (e.g. brain disease, sensory impairment) and external insults (e.g. physical illness, medication), the rates of which both increase with age. Our current concept of delirium derives principally from the florid clinical stereotype that has evolved from centuries of clinical observations on younger patients, and it may not be applicable to our historically unique ageing population. In younger adults, a major physical insult is usually necessary to precipitate delirium, which is often a dramatic disturbance. This is not the case in vulnerable elderly patients when relatively mild physical, psychological, or environmental upsets may be sufficient to bring about acute disturbances of mental functioning. These disturbances may be less obvious than in younger patients, particularly if they occur in the context of pre-existing cognitive impairment. Consequently, despite being common and problematic, delirium in elderly patients is frequently missed or misdiagnosed as dementia or depression by medical and nursing staff. This is unfortunate, because delirium is an important non-specific sign of physical illness or intoxication, and if left untreated there may be costly consequences, both for the patient and for health services.
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- Section 1 The Subject Matter of and Approach to Psychiatry
- 1.3 Psychiatry as a worldwide public health problem
- 1.4 The history of psychiatry as a medical specialty
- 1.5 Ethics and values
- 1.6 The psychiatrist as a manager
- 1.7 Descriptive phenomenology
- 1.8 Assessment
- 1.9 Diagnosis and classification
- 1.10 From science to practice
- Section 2 The Scientific Basis of Psychiatric Aetiology
- 2.3 The contribution of neurosciences
- 2.4 The contribution of genetics
- 2.5 The contribution of psychological science
- 2.6 The contribution of social sciences
- 2.7 The contribution of epidemiology to psychiatric aetiology
- Section 3 Psychodynamic Contributions to Psychiatry
- Section 4 Clinical Syndromes of Adult Psychiatry
- 4.4 Persistent delusional symptoms and disorders
- 4.5 Mood disorders
- 4.6 Stress-related and adjustment disorders
- 4.7 Anxiety disorders
- Section 5 Psychiatry and Medicine
- Section 6 Treatment Methods in Psychiatry
- 6.2 Somatic treatments
- Section 7 Social Psychiatry and Service Provision
- Section 8 The Psychiatry of Old Age
- 8.1 The biology of ageing
- 8.2 Sociology of normal ageing
- 8.3 The ageing population and the epidemiology of mental disorders among the elderly
- 8.4 Assessment of mental disorder in older patients
- 8.5 Special features of clinical syndromes in the elderly
- 8.5.1 Delirium in the elderly
- 8.5.1.1 Mild cognitive impairment
- 8.5.2 Substance use disorders in older people
- 8.5.3 Schizophrenia and paranoid disorders in late life
- 8.5.4 Mood disorders in the elderly
- 8.5.5 Stress-related, anxiety, and obsessional disorders in elderly people
- 8.5.6 Personality disorders in the elderly
- 8.5.7 Suicide and deliberate self-harm in elderly people
- 8.5.8 Sex in old age
- 8.6 Special features of psychiatric treatment for the elderly
- 8.7 The planning and organization of services for older adults
- Section 9 Child and Adolescent Psychiatry