Unlabelled: Delirium is a common disorder associated with poor prognosis, especially in the elderly. The impact of different treatment approaches for delirium on morbimortality and long-term welfare is not completely understood.
Objective: To determine the efficacy of pharmacological and non-pharmacological treatments in elderly patients with delirium.
Methods: This systematic review compared pharmacological and non-pharmacological treatments in patients over 60 years old with delirium. Databases used were: MEDLINE (PubMed), EMBASE, Cochrane CENTRAL and LILACS from inception to January 6, 2016.
Results: A total of ten articles were selected. The six non-pharmacological intervention studies showed no impact on duration of delirium, mortality or institutionalization, but a decrease in severity of delirium and improvement in medium-term cognitive function were observed. The most commonly used interventions were temporal-spatial orientation, orientation to self and others, early mobilization and sleep hygiene. The four studies with pharmacological interventions found that rivastigmine reduced the duration of delirium, improved cognitive function and reduced caregiver burden; olanzapine and haloperidol decreased the severity of delirium; droperidol reduced length of hospitalization and improved delirium remission rate.
Conclusion: Although the pharmacological approach has been used in the treatment of delirium among elderly, there have been few studies assessing its efficacy, involving a small number of patients. However, the improvements in delirium duration and severity suggest these drugs are effective in treating the condition. Once delirium has developed, non-pharmacological treatment seems less effective in controlling symptoms, and there is a lack of studies describing different non-pharmacological interventions.
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http://dx.doi.org/10.1590/1980-57642016dn11-030009 | DOI Listing |
PLoS One
January 2025
Department of Diagnostic and Health Sciences, College of Health Professions, University of Tennessee Health Science Center, Memphis, TN, United States of America.
For patients hospitalized with COVID-19, delirium is a serious and under-recognized complication, and people experiencing homelessness (PEH) may be at greater risk. This retrospective cohort study compared delirium-associated risk factors and clinical outcomes between PEH and non-PEH. This study used patient records from 154 hospitals discharged from 2020-2021 from the Texas Inpatient Public Use Data file.
View Article and Find Full Text PDFBackground: Delirium is an acute state of confusion associated with adverse postoperative outcomes. Delirium is diagnosed clinically using screening tools; most cases go undetected. Identifying a delirium biomarker would allow for accurate diagnosis, application of therapies, and insight into causal pathways.
View Article and Find Full Text PDFJMIR Perioper Med
January 2025
Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, United States.
Background: Postoperative delirium (POD) is a common complication after major surgery and is associated with poor outcomes in older adults. Early identification of patients at high risk of POD can enable targeted prevention efforts. However, existing POD prediction models require inpatient data collected during the hospital stay, which delays predictions and limits scalability.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Weill Cornell Medicine, New York, NY, USA; St Vincent's Hospital, Melbourne, VIC, Australia.
Background: Postoperative delirium (POD) is a serious complication of surgery associated with prolonged hospitalisation, long-term cognitive decline, dementia and mortality. There is increasing evidence that electroencephalography (EEG) monitoring may reduce the incidence of POD, however, the best method for achieving this is unclear.
Method: This presentation will present the results of a multicentre randomised clinical trial of 515 at-risk patients undergoing major surgery from 8 centres in 3 countries who were assessed for POD for 5 days postoperatively.
Background: Delirium is a common neurological complication in older adults after a major illness or surgery and is characterized by acute dysfunction in cognition, attention, and awareness. Once diagnosed, it is associated with an increased risk for dementia. Frailty is an age-related syndrome and is associated with poorer postoperative outcomes, and is an emerging risk factor for delirium.
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