Acute Delirium in the Elderly: Diagnosis and Management

  • Nages Nagaratnam
  • Kujan Nagaratnam
  • Gary Cheuk
Reference work entry


Delirium is a disorder in which high cognitive and integrative functions become defective, resulting in disturbance of global inattention and attention-directed disorders. In DSM-5 the term ‘consciousness’ is no longer used, but no major changes had been made to the core elements of DSM-5 criteria for delirium. The changes to DSM-5 include (1) disturbance in attention and orientation to the environment; (2) disturbance that develops in a short period of time; (3) a change in the cognitive domain such as in memory, language and orientation; and (4) disturbances 1 and 3 that should not occur in the context of a severely reduced level of arousal such as coma. Although this excludes coma, as being characterised as delirium, severe inattention can be deemed to occur where there is reduced arousal impairing cognitive testing. The pathophysiology of delirium is complex and the mechanisms poorly understood. Severe deleterious effects on brain function can result from systemic inflammatory signals in the elderly in the presence of neurodegenerative disease. It is recognised as an important cause of morbidity and mortality


Delirium Acute confusional state S100B a putative marker of CNS injury DSM-5 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Nages Nagaratnam
    • 1
  • Kujan Nagaratnam
    • 1
  • Gary Cheuk
    • 2
  1. 1.The University of SydneyWestmead Clinical SchoolWestmeadAustralia
  2. 2.Rehabilitation and Aged Care ServiceBlacktown-Mt Druitt HospitalMount DruittAustralia

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