Delirium in Older People

Dear Colleagues,

Delirium is a neuropsychiatric syndrome manifesting in a sudden and fluctuating impairment of attention, awareness and cognitive function, and is particularly common in older adults with acute illness. This syndrome affects 10–15% of older patients in the emergency department, up to 30% in general medical wards and 15–25% following elective surgical procedures associated with poor outcomes. The most common triggers of delirium include acute infections, metabolic conditions, iatrogenic complications, surgery, trauma, uncontrolled pain and medications.

The clinical relevance of delirium has led to the development of several guidelines regarding the prevention, recognition, diagnosis and treatment of this syndrome. As delirium remains a major diagnostic challenge, a significant amount of research is being dedicated to developing reliable tools to improve the recognition of this syndrome in clinical practice. At the same time, as a translational perspective is being increasingly used in delirium research, several pathophysiological hypotheses are being tested, incorporating both basic science and clinical research findings. Indeed, the progressive understanding of the fundamental neurobiological processes underlying delirium will allow for a more precise definition and classification of this syndrome, the development of biomarkers enabling the diagnosis at the pre-symptomatic stage, monitoring the clinical evolution and predicting the clinical outcome. Ultimately, this will also have implications for the development of more effective approaches to prevent delirium and slow the progression or retard the clinical manifestations of neurodegenerative disorders.

Dr. Joaquim Cerejeira
Guest Editor

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• delirium
• older people