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Delirium

  • Living reference work entry
  • First Online:
Mental Health and Illness of the Elderly

Part of the book series: Mental Health and Illness Worldwide ((MHIW))

  • 161 Accesses

Abstract

Currently, the elderly remain at high risk for the development of delirium and the significant morbidity and mortality associated with it in all care settings. While significant advancements have been made through research and collaboration among clinicians in diverse specialty fields, some controversies still remain. The initial literature search performed for the chapter revealed over 3000 articles published from January 1990 to May 2016. The initial list was refined to around 200 original research articles for review. This chapter summarizes the controversies, collaborations, and recent advancements in the management of delirium in the elderly.

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References

  • Al-Aama T, Brymer C, Gutmanis I, Woolmore-Goodwin SM, Esbaugh J, Dasgupta M (2011) Melatonin decreases delirium in elderly patients: a randomized, placebo-controlled trial. Int J Geriatr Psychiatry 26(7):687–694. doi:10.1002/gps.2582

    Article  PubMed  Google Scholar 

  • Alao AO, Moskowitz L (2006) Aripiprazole and delirium. Ann Clin Psychiatry 18(4):267–269

    Article  PubMed  Google Scholar 

  • Al-Qadheeb NS, Skrobik Y, Schumaker G, Pacheco MN, Roberts RJ, Ruthazer RR, Devlin JW (2016) Preventing ICU subsyndromal delirium conversion to delirium with low-dose IV haloperidol: a double-blind, placebo-controlled pilot study. Crit Care Med 44(3):583–591. doi:10.1097/CCM.0000000000001411

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, Washington, DC

    Book  Google Scholar 

  • Artemiou P, Bily B, Bilecova-Rabajdova M, Sabol F, Torok P, Kolarcik P, Kolesar A (2015) Melatonin treatment in the prevention of postoperative delirium in cardiac surgery patients. Kardiochir Torakochirurgia Pol 12(2):126–133. doi:10.5114/kitp.2015.52853

    PubMed  PubMed Central  Google Scholar 

  • Boettger S, Breitbart W (2011) An open trial of aripiprazole for the treatment of delirium in hospitalized cancer patients. Palliat Support Care 9(4):351–357. doi:10.1017/S1478951511000368

    Article  PubMed  Google Scholar 

  • Bourgeois JA, Koike AK, Simmons JE, Telles S, Eggleston C (2005) Adjunctive valproic acid for delirium and/or agitation on a consultation-liaison service: a report of six cases. J Neuropsychiatry Clin Neurosci 17(2):232–238

    Article  CAS  PubMed  Google Scholar 

  • Brown CH 4th, Faigle R, Klinker L, Bahouth M, Max L, LaFlam A, Neufeld KJ, Mandal K, Gottesman RF, Hogue CW Jr (2015) The association of brain MRI characteristics and postoperative delirium in cardiac surgery patients. Clin Ther 37(12):2686–2699.e9. doi:10.1016/j.clinthera.2015.10.021

    Article  PubMed  PubMed Central  Google Scholar 

  • Cavallari M, Hshieh TT, Guttmann CR, Ngo LH, Meier DS, Schmitt EM, Marcantonio ER, Jones RN, Kosar CM, Fong TG, Press D, Inouye SK, Alsop DC, SAGES Study Group (2015) Brain atrophy and white-matter hyperintensities are not significantly associated with incidence and severity of postoperative delirium in older persons without dementia. Neurobiol Aging 36(6):2122–2129. doi:10.1016/j.neurobiolaging.2015.02.024

    Article  PubMed  PubMed Central  Google Scholar 

  • Cavallari M, Dai W, Guttmann CR, Meier DS, Ngo LH, Hshieh TT, Callahan AE, Fong TG, Schmitt E, Dickerson BC, Press DZ, Marcantonio ER, Jones RN, Inouye SK, Alsop DC, SAGES Study Group (2016) Neural substrates of vulnerability to postsurgical delirium as revealed by presurgical diffusion MRI. Brain 139(Pt 4):1282–1294. doi:10.1093/brain/aww010

    Article  PubMed  PubMed Central  Google Scholar 

  • Chen S, Shi L, Liang F, Xu L, Desislava D, Wu Q, Zhang J (2015) Exogenous melatonin for delirium prevention: a meta-analysis of randomized controlled trials. Mol Neurobiol. [Epub ahead of print]

    Google Scholar 

  • Clarke HA, Katz J, McCartney CJ, Stratford P, Kennedy D, Pagé MG, Awad IT, Gollish J, Kay J (2014) Perioperative gabapentin reduces 24 h opioid consumption and improves in-hospital rehabilitation but not post-discharge outcomes after total knee arthroplasty with peripheral nerve block. Br J Anaesth 113(5):855–864. doi:10.1093/bja/aeu202

    Article  CAS  PubMed  Google Scholar 

  • Cohen MB, Stewart JT (2013) Treatment of post-electroconvulsive therapy agitation with dexmedetomidine. J ECT 29(2):e23–e24. doi:10.1097/YCT.0b013e31827e56a7

    Article  PubMed  Google Scholar 

  • Cole MG, Ciampi A, Belzile E, Dubuc-Sarrasin M (2013) Subsyndromal delirium in older people: a systematic review of frequency, risk factors, course and outcomes. Int J Geriatr Psychiatry 28(8):771–780. doi:10.1002/gps.3891

    Article  PubMed  Google Scholar 

  • Colombo R, Corona A, Praga F, Minari C, Giannotti C, Castelli A, Raimondi F (2012) A reorientation strategy for reducing delirium in the critically ill. Results of an interventional study. Minerva Anestesiol 78(9):1026–1033

    CAS  PubMed  Google Scholar 

  • Constantin JM, Momon A, Mantz J, Payen JF, De Jonghe B, Perbet S, Cayot S, Chanques G, Perreira B (2016) Efficacy and safety of sedation with dexmedetomidine in critical care patients: a meta-analysis of randomized controlled trials. Anaesth Crit Care Pain Med 35(1):7–15. doi:10.1016/j.accpm.2015.06.012

    Article  PubMed  Google Scholar 

  • Dautzenberg PL, Mulder LJ, Olde Rikkert MG, Wouters CJ, Loonen AJ (2004) Delirium in elderly hospitalised patients: protective effects of chronic rivastigmine usage. Int J Geriatr Psychiatry 19(7):641–644

    Article  PubMed  Google Scholar 

  • Davidson JE, Harvey MA, Bemis-Dougherty A, Smith JM, Hopkins RO (2013) Implementation of the pain, agitation, and delirium clinical practice guidelines and promoting patient mobility to prevent post-intensive care syndrome. Crit Care Med 41(9 Suppl 1):S136–S145. doi:10.1097/CCM.0b013e3182a24105

    Article  PubMed  Google Scholar 

  • Davydow DS, Gifford JM, Desai SV, Needham DM, Bienvenu OJ (2008) Posttraumatic stress disorder in general intensive care unit survivors: a systematic review. Gen Hosp Psychiatry 30(5):421–434. doi:10.1016/j.genhosppsych.2008.05.006

    Article  PubMed  PubMed Central  Google Scholar 

  • de Jonghe A, Korevaar JC, van Munster BC, de Rooij SE (2010) Effectiveness of melatonin treatment on circadian rhythm disturbances in dementia. Are there implications for delirium? A systematic review. Int J Geriatr Psychiatry 25(12):1201–1208. doi:10.1002/gps.2454

    Article  PubMed  Google Scholar 

  • de Jonghe A, van Munster BC, Goslings JC, Kloen P, van Rees C, Wolvius R, van Velde R, Levi M, de Haan RJ, de Rooij SE, Amsterdam Delirium Study Group (2014) Effect of melatonin on incidence of delirium among patients with hip fracture: a multicentre, double-blind randomized controlled trial. CMAJ 186(14):E547–E556. doi:10.1503/cmaj.140495

    Article  PubMed  PubMed Central  Google Scholar 

  • de Rooij SE, van Munster BC, de Jonghe A (2014) Melatonin prophylaxis in delirium: panacea or paradigm shift? JAMA Psychiatry 71(4):364–365. doi:10.1001/jamapsychiatry.2013.4532

    Article  PubMed  Google Scholar 

  • Detweiler MB, Mehra A, Rowell T, Kim KY, Bader G (2009) Delirious mania and malignant catatonia: a report of 3 cases and review. Psychiatr Q 80(1):23–40. doi:10.1007/s11126-009-9091-9

    Article  PubMed  Google Scholar 

  • Dianatkhah M, Ghaeli P, Hajhossein Talasaz A, Karimi A, Salehiomran A, Bina P, Jalali A, Ghaffary S, Shahmansouri N, Vejdani S (2015) Evaluating the potential effect of melatonin on the post-cardiac surgery sleep disorder. J Tehran Heart Cent 10(3):122–128

    PubMed  PubMed Central  Google Scholar 

  • Dighe K, Clarke H, McCartney CJ, Wong CL (2014) Perioperative gabapentin and delirium following total knee arthroplasty: a post-hoc analysis of a double-blind randomized placebo-controlled trial. Can J Anaesth 61(12):1136–1137. doi:10.1007/s12630-014-0235-5

    Article  PubMed  Google Scholar 

  • Djaiani G, Silverton N, Fedorko L, Carroll J, Styra R, Rao V, Katznelson R (2016) Dexmedetomidine versus propofol sedation reduces delirium after cardiac surgery: a randomized controlled trial. Anesthesiology 124(2):362–368. doi:10.1097/ALN.0000000000000951

    Article  CAS  PubMed  Google Scholar 

  • Fink M, Taylor MA (eds) (2003) Catatonia: a clinician’s guide to diagnosis and treatment. Cambridge University Press, Cambridge

    Google Scholar 

  • Finucane AM, Lugton J, Kennedy C, Spiller JA (2016) The experiences of caregivers of patients with delirium, and their role in its management in palliative care settings: an integrative literature review. Psychooncology. doi:10.1002/pon.4140. [Epub ahead of print]

    PubMed  PubMed Central  Google Scholar 

  • Fong TG, Jones RN, Shi P, Marcantonio ER, Yap L, Rudolph JL, Yang FM, Kiely DK, Inouye SK (2009) Delirium accelerates cognitive decline in Alzheimer disease. Neurology 72(18):1570–1575. doi:10.1212/WNL.0b013e3181a4129a

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Ford AH, Almeida OP (2015) Pharmacological interventions for preventing delirium in the elderly. Maturitas 81(2):287–292. doi:10.1016/j.maturitas.2015.03.024

    Article  CAS  PubMed  Google Scholar 

  • Fukata S, Kawabata Y, Fujisiro K, Katagawa Y, Kuroiwa K, Akiyama H, Terabe Y, Ando M, Kawamura T, Hattori H (2014) Haloperidol prophylaxis does not prevent postoperative delirium in elderly patients: a randomized, open-label prospective trial. Surg Today 44(12):2305–2313. doi:10.1007/s00595-014-0859-7

    Article  CAS  PubMed  Google Scholar 

  • Gagnon B, Low G, Schreier G (2005) Methylphenidate hydrochloride improves cognitive function in patients with advanced cancer and hypoactive delirium: a prospective clinical study. J Psychiatry Neurosci 30(2):100–107

    PubMed  PubMed Central  Google Scholar 

  • Gagnon DJ, Riker RR, Glisic EK, Kelner A, Perrey HM, Fraser GL (2015) Transition from dexmedetomidine to enteral clonidine for ICU sedation: an observational pilot study. Pharmacotherapy 35(3):251–259. doi:10.1002/phar.1559

    Article  CAS  PubMed  Google Scholar 

  • Gamberini M, Bolliger D, Lurati Buse GA, Burkhart CS, Grapow M, Gagneux A, Filipovic M, Seeberger MD, Pargger H, Siegemund M, Carrel T, Seiler WO, Berres M, Strebel SP, Monsch AU, Steiner LA (2009) Rivastigmine for the prevention of postoperative delirium in elderly patients undergoing elective cardiac surgery – a randomized controlled trial. Crit Care Med 37(5):1762–1768. doi:10.1097/CCM.0b013e31819da780

    Article  CAS  PubMed  Google Scholar 

  • Girard TD, Shintani AK, Jackson JC, Gordon SM, Pun BT, Henderson MS, Dittus RS, Bernard GR, Ely EW (2007) Risk factors for post-traumatic stress disorder symptoms following critical illness requiring mechanical ventilation: a prospective cohort study. Crit Care 11(1):R28

    Article  PubMed  PubMed Central  Google Scholar 

  • Gross AF, Stern TA (2014) Neuropsychiatric conditions associated with anesthesia exposure. Psychosomatics 55(1):21–28. doi:10.1016/j.psym.2013.06.020

    Article  PubMed  Google Scholar 

  • Gross AL, Jones RN, Habtemariam DA, Fong TG, Tommet D, Quach L, Schmitt E, Yap L, Inouye SK (2012) Delirium and long-term cognitive trajectory among persons with dementia. Arch Intern Med 172(17):1324–1331. doi:10.1001/archinternmed.2012.3203

    Article  PubMed  PubMed Central  Google Scholar 

  • Hakim SM, Othman AI, Naoum DO (2012) Early treatment with risperidone for subsyndromal delirium after on-pump cardiac surgery in the elderly: a randomized trial. Anesthesiology 116(5):987–997. doi:10.1097/ALN.0b013e31825153cc

    Article  CAS  PubMed  Google Scholar 

  • Hatano Y, Narumoto J, Shibata K, Matsuoka T, Taniguchi S, Hata Y, Yamada K, Yaku H, Fukui K (2013) White-matter hyperintensities predict delirium after cardiac surgery. Am J Geriatr Psychiatry 21(10):938–945. doi:10.1016/j.jagp.2013.01.061

    Article  PubMed  Google Scholar 

  • Hatta K, Kishi Y, Wada K, Takeuchi T, Odawara T, Usui C, Nakamura H, DELIRIA-J Group (2014) Preventive effects of ramelteon on delirium: a randomized placebo-controlled trial. JAMA Psychiatry 71(4):397–403. doi:10.1001/jamapsychiatry.2013.3320

    Article  CAS  PubMed  Google Scholar 

  • Hirota T, Kishi T (2013) Prophylactic antipsychotic use for postoperative delirium: a systematic review and meta-analysis. J Clin Psychiatry 74(12):e1136–e1144. doi:10.4088/JCP.13r08512

    Article  CAS  PubMed  Google Scholar 

  • Inouye SK (2006) Delirium in older persons. N Engl J Med 354(11):1157–1165

    Article  CAS  PubMed  Google Scholar 

  • Inouye SK, Bogardus ST Jr, Charpentier PA, Leo-Summers L, Acampora D, Holford TR, Cooney LM Jr (1999) A multicomponent intervention to prevent delirium in hospitalized older patients. N Engl J Med 340(9):669–676

    Article  CAS  PubMed  Google Scholar 

  • Inouye SK, Bogardus ST Jr, Baker DI, Leo-Summers L, Cooney LM Jr (2000) The hospital elder life program: a model of care to prevent cognitive and functional decline in older hospitalized patients. Hospital elder life program. J Am Geriatr Soc 48(12):1697–1706

    Article  CAS  PubMed  Google Scholar 

  • Inouye SK, Westendorp RG, Saczynski JS (2014) Delirium in elderly people. Lancet 383(9920):911–922. doi:10.1016/S0140-6736(13)60688-1

    Article  PubMed  Google Scholar 

  • Jackson JC, Pandharipande PP, Girard TD, Brummel NE, Thompson JL, Hughes CG, Pun BT, Vasilevskis EE, Morandi A, Shintani AK, Hopkins RO, Bernard GR, Dittus RS, Ely EW, Bringing to light the Risk Factors And Incidence of Neuropsychological dysfunction in ICU survivors (BRAIN-ICU) study investigators (2014) Depression, post-traumatic stress disorder, and functional disability in survivors of critical illness in the BRAIN-ICU study: a longitudinal cohort study. Lancet Respir Med 2(5):369–379. doi:10.1016/S2213-2600(14)70051-7

    Article  PubMed  PubMed Central  Google Scholar 

  • Jackson JC, Morandi A, Girard TD, Merkle K, Graves AJ, Thompson JL, Shintani AK, Gunther ML, Cannistraci CJ, Rogers BP, Gore JC, Warrington HJ, Ely EW, Hopkins RO, VISualizing Icu SurvivOrs Neuroradiological Sequelae (VISIONS) Investigation (2015) Functional brain imaging in survivors of critical illness: a prospective feasibility study and exploration of the association between delirium and brain activation patterns. J Crit Care 30(3):653.e1–653.e7. doi:10.1016/j.jcrc.2015.01.017

    Article  Google Scholar 

  • Jacobi J, Fraser GL, Coursin DB, Riker RR, Fontaine D, Wittbrodt ET, Chalfin DB, Masica MF, Bjerke HS, Coplin WM, Crippen DW, Fuchs BD, Kelleher RM, Marik PE, Nasraway SA Jr, Murray MJ, Peruzzi WT, Lumb PD, Task Force of the American College of Critical Care Medicine (ACCM) of the Society of Critical Care Medicine (SCCM), American Society of Health-System Pharmacists (ASHP), American College of Chest Physicians (2002) Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Crit Care Med 30(1):119–141

    Article  PubMed  Google Scholar 

  • Jacobowski NL, Heckers S, Bobo WV (2013) Delirious mania: detection, diagnosis, and clinical management in the acute setting. J Psychiatr Pract 19(1):15–28. doi:10.1097/01.pra.0000426324.67322.06

    Article  PubMed  Google Scholar 

  • Jakob SM, Ruokonen E, Grounds RM, Sarapohja T, Garratt C, Pocock SJ, Bratty JR, Takala J, Dexmedetomidine for Long-Term Sedation Investigators (2012) Dexmedetomidine vs midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials. JAMA 307(11):1151–1160. doi:10.1001/jama.2012.304

    Article  CAS  PubMed  Google Scholar 

  • Kalisvaart KJ, de Jonghe JF, Bogaards MJ, Vreeswijk R, Egberts TC, Burger BJ, Eikelenboom P, van Gool WA (2005) Haloperidol prophylaxis for elderly hip-surgery patients at risk for delirium: a randomized placebo-controlled study. J Am Geriatr Soc 53(10):1658–1666

    Article  PubMed  Google Scholar 

  • Larsen KA, Kelly SE, Stern TA, Bode RH Jr, Price LL, Hunter DJ, Gulczynski D, Bierbaum BE, Sweeney GA, Hoikala KA, Cotter JJ, Potter AW (2010) Administration of olanzapine to prevent postoperative delirium in elderly joint-replacement patients: a randomized, controlled trial. Psychosomatics 51(5):409–418. doi:10.1176/appi.psy.51.5.409

    Article  CAS  PubMed  Google Scholar 

  • Lee BS, Huang SS, Hsu WY, Chiu NY (2012) Clinical features of delirious mania: a series of five cases and a brief literature review. BMC Psychiatry 12:65. doi:10.1186/1471-244X-12-65

    Article  PubMed  PubMed Central  Google Scholar 

  • Leung JM, Sands LP, Rico M, Petersen KL, Rowbotham MC, Dahl JB, Ames C, Chou D, Weinstein P (2006) Pilot clinical trial of gabapentin to decrease postoperative delirium in older patients. Neurology 67(7):1251–1253

    Article  CAS  PubMed  Google Scholar 

  • Liptzin B, Levkoff SE (1992) An empirical study of delirium subtypes. Br J Psychiatry 161:843–845

    Article  CAS  PubMed  Google Scholar 

  • Liptzin B, Laki A, Garb JL, Fingeroth R, Krushell R (2005) Donepezil in the prevention and treatment of post-surgical delirium. Am J Geriatr Psychiatry 13(12):1100–1106

    Article  PubMed  Google Scholar 

  • Lloyd RB, Rosenthal LJ (2015) Acute traumatic and depressive symptoms in family members of hospitalized individuals with delirium. Int J Psychiatry Med 50(2):191–202. doi:10.1177/0091217415605033

    Article  PubMed  Google Scholar 

  • Lundström M, Olofsson B, Stenvall M, Karlsson S, Nyberg L, Englund U, Borssén B, Svensson O, Gustafson Y (2007) Postoperative delirium in old patients with femoral neck fracture: a randomized intervention study. Aging Clin Exp Res 19(3):178–186

    Article  PubMed  Google Scholar 

  • Maldonado JR (2013) Neuropathogenesis of delirium: review of current etiologic theories and common pathways. Am J Geriatr Psychiatry 21(12):1190–1222. doi:10.1016/j.jagp.2013.09.005

    Article  PubMed  Google Scholar 

  • Maldonado JR (2015) Delirium: neurobiology, characteristics, and management. In: Fogel BS, Greenberg DB (eds) Psychiatric care of the medical patient, 3rd edn. Oxford University Press, New York, pp 823–907

    Chapter  Google Scholar 

  • Maldonado JR, Wysong A, van der Starre PJ, Block T, Miller C, Reitz BA (2009) Dexmedetomidine and the reduction of postoperative delirium after cardiac surgery. Psychosomatics 50(3):206–217. doi:10.1176/appi.psy.50.3.206

    Article  CAS  PubMed  Google Scholar 

  • Marcantonio ER, Flacker JM, Wright RJ, Resnick NM (2001) Reducing delirium after hip fracture: a randomized trial. J Am Geriatr Soc 49(5):516–522

    Article  CAS  PubMed  Google Scholar 

  • Marcantonio ER, Palihnich K, Appleton P, Davis RB (2011) Pilot randomized trial of donepezil hydrochloride for delirium after hip fracture. J Am Geriatr Soc 59(Suppl 2):S282–S288. doi:10.1111/j.1532-5415.2011.03691.x

    Article  PubMed  PubMed Central  Google Scholar 

  • Meagher DJ, Leonard M, Donnelly S, Conroy M, Adamis D, Trzepacz PT (2012) A longitudinal study of motor subtypes in delirium: frequency and stability during episodes. J Psychosom Res 72(3):236–241. doi:10.1016/j.jpsychores.2011.11.013

    Article  PubMed  Google Scholar 

  • Meagher D, O’Regan N, Ryan D, Connolly W, Boland E, O’Caoimhe R, Clare J, Mcfarland J, Tighe S, Leonard M, Adamis D, Trzepacz PT, Timmons S (2014) Frequency of delirium and subsyndromal delirium in an adult acute hospital population. Br J Psychiatry 205(6):478–485. doi:10.1192/bjp.bp.113.139865

    Article  CAS  PubMed  Google Scholar 

  • Michaud CJ, Bullard HM, Harris SA, Thomas WL (2015) Impact of quetiapine treatment on duration of hypoactive delirium in critically ill adults: a retrospective analysis. Pharmacotherapy 35(8):731–739. doi:10.1002/phar.1619

    Article  CAS  PubMed  Google Scholar 

  • Miura S, Furuya M, Yasuda H, Miyaoka T, Horiguchi J (2015) Novel therapy with ramelteon for hypoactive delirium: a case report. J Clin Psychopharmacol 35(5):616–618. doi:10.1097/JCP.0000000000000370

    Article  PubMed  Google Scholar 

  • Moretti R, Torre P, Antonello RM, Cattaruzza T, Cazzato G (2004) Cholinesterase inhibition as a possible therapy for delirium in vascular dementia: a controlled, open 24-month study of 246 patients. Am J Alzheimers Dis Other Demen 19(6):333–339

    Article  PubMed  Google Scholar 

  • Munk L, Andersen G, Møller AM (2016) Post-anaesthetic emergence delirium in adults: incidence, predictors and consequences. Acta Anaesthesiol Scand. doi:10.1111/aas.12717. [Epub ahead of print]

    PubMed  Google Scholar 

  • Nelson S, Rustad JK, Catalano G, Stern TA, Kozel FA (2016) Depressive symptoms before, during, and after delirium: a literature review. Psychosomatics 57(2):131–141. doi:10.1016/j.psym.2015.11.003

    Article  PubMed  Google Scholar 

  • Neufeld KJ, Yue J, Robinson TN, Inouye SK, Needham DM (2016) Antipsychotic medication for prevention and treatment of delirium in hospitalized adults: a systematic review and meta-analysis. J Am Geriatr Soc 64(4):705–714. doi:10.1111/jgs.14076

    Article  PubMed  PubMed Central  Google Scholar 

  • Oldenbeuving AW, de Kort PL, Jansen BP, Kappelle LJ, Roks G (2008) A pilot study of rivastigmine in the treatment of delirium after stroke: a safe alternative. BMC Neurol 8:34. doi:10.1186/1471-2377-8-34

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Oldham MA, Lee HB, Desan PH (2016) Circadian rhythm disruption in the critically ill: an opportunity for improving outcomes. Crit Care Med 44(1):207–217. doi:10.1097/CCM.0000000000001282

    Article  PubMed  Google Scholar 

  • O’Mahony R, Murthy L, Akunne A, Young J, Guideline Development Group (2011) Synopsis of the national institute for health and clinical excellence guideline for prevention of delirium. Ann Intern Med 154(11):746–751. doi:10.7326/0003-4819-154-11-201106070-00006

    Article  PubMed  Google Scholar 

  • Omiya H, Yoshitani K, Yamada N, Kubota Y, Takahashi K, Kobayashi J, Ohnishi Y (2015) Preoperative brain magnetic resonance imaging and postoperative delirium after off-pump coronary artery bypass grafting: a prospective cohort study. Can J Anaesth 62(6):595–602. doi:10.1007/s12630-015-0327-x

    Article  PubMed  Google Scholar 

  • O’Sullivan R, Inouye SK, Meagher D (2014) Delirium and depression: inter-relationship and clinical overlap in elderly people. Lancet Psychiatry 1(4):303–311. doi:10.1016/S2215-0366(14)70281-0

    Article  PubMed  PubMed Central  Google Scholar 

  • Pandharipande PP, Pun BT, Herr DL, Maze M, Girard TD, Miller RR, Shintani AK, Thompson JL, Jackson JC, Deppen SA, Stiles RA, Dittus RS, Bernard GR, Ely EW (2007) Effect of sedation with dexmedetomidine vs lorazepam on acute brain dysfunction in mechanically ventilated patients: the MENDS randomized controlled trial. JAMA 298(22):2644–2653

    Article  CAS  PubMed  Google Scholar 

  • Partridge JS, Martin FC, Harari D, Dhesi JK (2013) The delirium experience: what is the effect on patients, relatives and staff and what can be done to modify this? Int J Geriatr Psychiatry 28(8):804–812. doi:10.1002/gps.3900

    Article  PubMed  Google Scholar 

  • Pasin L, Landoni G, Nardelli P, Belletti A, Di Prima AL, Taddeo D, Isella F, Zangrillo A (2014) Dexmedetomidine reduces the risk of delirium, agitation and confusion in critically ill patients: a meta-analysis of randomized controlled trials. J Cardiothorac Vasc Anesth 28(6):1459–1466. doi:10.1053/j.jvca.2014.03.010

    Article  CAS  PubMed  Google Scholar 

  • Peritogiannis V, Bolosi M, Lixouriotis C, Rizos DV (2015) Recent insights on prevalence and corelations of hypoactive delirium. Behav Neurol 2015:416792. doi:10.1155/2015/416792

    Article  PubMed  PubMed Central  Google Scholar 

  • Pickard A, Davies P, Birnie K, Beringer R (2014) Systematic review and meta-analysis of the effect of intraoperative α2-adrenergic agonists on postoperative behaviour in children. Br J Anaesth 112(6):982–990. doi:10.1093/bja/aeu093

    Article  CAS  PubMed  Google Scholar 

  • Prakanrattana U, Prapaitrakool S (2007) Efficacy of risperidone for prevention of postoperative delirium in cardiac surgery. Anaesth Intensive Care 35(5):714–719

    CAS  PubMed  Google Scholar 

  • Reade MC, O’Sullivan K, Bates S, Goldsmith D, Ainslie WR, Bellomo R (2009) Dexmedetomidine vs. haloperidol in delirious, agitated, intubated patients: a randomised open-label trial. Crit Care 13(3):R75. doi:10.1186/cc7890

    Article  PubMed  PubMed Central  Google Scholar 

  • Riker RR, Shehabi Y, Bokesch PM, Ceraso D, Wisemandle W, Koura F, Whitten P, Margolis BD, Byrne DW, Ely EW, Rocha MG, SEDCOM (Safety and Efficacy of Dexmedetomidine Compared With Midazolam) Study Group (2009) Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial. JAMA 301(5):489–499. doi:10.1001/jama.2009.56

    Article  CAS  PubMed  Google Scholar 

  • Rubin FH, Neal K, Fenlon K, Hassan S, Inouye SK (2011) Sustainability and scalability of the hospital elder life program at a community hospital. J Am Geriatr Soc 59(2):359–365. doi:10.1111/j.1532-5415.2010.03243.x

    Article  PubMed  PubMed Central  Google Scholar 

  • Rubino AS, Onorati F, Caroleo S, Galato E, Nucera S, Amantea B, Santini F, Renzulli A (2010) Impact of clonidine administration on delirium and related respiratory weaning after surgical correction of acute type-A aortic dissection: results of a pilot study. Interact Cardiovasc Thorac Surg 10(1):58–62. doi:10.1510/icvts.2009.217562

    Article  PubMed  Google Scholar 

  • Salluh JI, Wang H, Schneider EB, Nagaraja N, Yenokyan G, Damluji A, Serafim RB, Stevens RD (2015) Outcome of delirium in critically ill patients: systematic review and meta-analysis. BMJ 350:h2538. doi:10.1136/bmj.h2538

    Article  PubMed  PubMed Central  Google Scholar 

  • Sampson EL, Raven PR, Ndhlovu PN, Vallance A, Garlick N, Watts J, Blanchard MR, Bruce A, Blizard R, Ritchie CW (2007) A randomized, double-blind, placebo-controlled trial of donepezil hydrochloride (Aricept) for reducing the incidence of postoperative delirium after elective total hip replacement. Int J Geriatr Psychiatry 22(4):343–349

    Article  PubMed  Google Scholar 

  • Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, Spears L, Miller M, Franczyk M, Deprizio D, Schmidt GA, Bowman A, Barr R, McCallister KE, Hall JB, Kress JP (2009) Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet 373(9678):1874–1882. doi:10.1016/S0140-6736(09)60658-9

    Article  PubMed  Google Scholar 

  • Serafim RB, Bozza FA, Soares M, do Brasil PE, Tura BR, Ely EW, Salluh JI (2015) Pharmacologic prevention and treatment of delirium in intensive care patients: a systematic review. J Crit Care 30(4):799–807. doi:10.1016/j.jcrc.2015.04.005

    Article  CAS  PubMed  Google Scholar 

  • Shehabi Y, Grant P, Wolfenden H, Hammond N, Bass F, Campbell M, Chen J (2009) Prevalence of delirium with dexmedetomidine compared with morphine based therapy after cardiac surgery: a randomized controlled trial (DEXmedetomidine COmpared to Morphine-DEXCOM Study). Anesthesiology 111(5):1075–1084. doi:10.1097/ALN.0b013e3181b6a783

    Article  CAS  PubMed  Google Scholar 

  • Sher Y, Miller AC, Lolak S, Ament A, Maldonado JR (2015) Adjunctive valproic acid in management-refractory hyperactive delirium: a case series and rationale. J Neuropsychiatry Clin Neurosci 27(4):365–370. doi:10.1176/appi.neuropsych.14080190

    Article  PubMed  Google Scholar 

  • Shim J, DePalma G, Sands LP, Leung JM (2015) Prognostic significance of postoperative subsyndromal delirium. Psychosomatics 56(6):644–651. doi:10.1016/j.psym.2015.05.002

    Article  PubMed  PubMed Central  Google Scholar 

  • Shioiri A, Kurumaji A, Takeuchi T, Nemoto K, Arai H, Nishikawa T (2016) A decrease in the volume of gray matter as a risk factor for postoperative delirium revealed by an atlas-based method. Am J Geriatr Psychiatry 24(7):528–536. doi:10.1016/j.jagp.2015.09.002

    Article  PubMed  Google Scholar 

  • Siddiqi N, Harrison JK, Clegg A, Teale EA, Young J, Taylor J, Simpkins SA (2016) Interventions for preventing delirium in hospitalised non-ICU patients. Cochrane Database Syst Rev 3:CD005563. doi:10.1002/14651858.CD005563.pub3

    PubMed  Google Scholar 

  • Slor CJ, Witlox J, Jansen RW, Adamis D, Meagher DJ, Tieken E, Houdijk AP, van Gool WA, Eikelenboom P, de Jonghe JF (2013) Affective functioning after delirium in elderly hip fracture patients. Int Psychogeriatr 25(3):445–455. doi:10.1017/S1041610212001962

    Article  PubMed  Google Scholar 

  • Straker DA, Shapiro PA, Muskin PR (2006) Aripiprazole in the treatment of delirium. Psychosomatics 47(5):385–391

    Article  CAS  PubMed  Google Scholar 

  • Strijbos MJ, Steunenberg B, van der Mast RC, Inouye SK, Schuurmans MJ (2013) Design and methods of the Hospital Elder Life Program (HELP), a multicomponent targeted intervention to prevent delirium in hospitalized older patients: efficacy and cost-effectiveness in Dutch health care. BMC Geriatr 13:78. doi:10.1186/1471-2318-13-78

    Article  PubMed  PubMed Central  Google Scholar 

  • Sultan SS (2010) Assessment of role of perioperative melatonin in prevention and treatment of postoperative delirium after hip arthroplasty under spinal anesthesia in the elderly. Saudi J Anaesth 4(3):169–173. doi:10.4103/1658-354X.71132

    Article  PubMed  PubMed Central  Google Scholar 

  • Tampi RR, Tampi DJ, Ghori AK (2016) Acetylcholinesterase inhibitors for delirium in older adults. Am J Alzheimers Dis Other Demen 31(4):305–310. doi:10.1177/1533317515619034

    Article  PubMed  Google Scholar 

  • Teslyar P, Stock VM, Wilk CM, Camsari U, Ehrenreich MJ, Himelhoch S (2013) Prophylaxis with antipsychotic medication reduces the risk of post-operative delirium in elderly patients: a meta-analysis. Psychosomatics 54(2):124–131. doi:10.1016/j.psym.2012.12.004

    Article  PubMed  Google Scholar 

  • Theisen-Toupal J, Breu AC, Mattison ML, Arnaout R (2014) Diagnostic yield of head computed tomography for the hospitalized medical patient with delirium. J Hosp Med 9(8):497–501. doi:10.1002/jhm.2198

    Article  PubMed  Google Scholar 

  • van den Boogaard M, Schoonhoven L, van Achterberg T, van der Hoeven JG, Pickkers P (2013) Haloperidol prophylaxis in critically ill patients with a high risk for delirium. Crit Care 17(1):R9. doi:10.1186/cc11933

    Article  PubMed  PubMed Central  Google Scholar 

  • van Eijk MM, Roes KC, Honing ML, Kuiper MA, Karakus A, van der Jagt M, Spronk PE, van Gool WA, van der Mast RC, Kesecioglu J, Slooter AJ (2010) Effect of rivastigmine as an adjunct to usual care with haloperidol on duration of delirium and mortality in critically ill patients: a multicentre, double-blind, placebo-controlled randomised trial. Lancet 376(9755):1829–1837. doi:10.1016/S0140-6736(10)61855-7

    Article  PubMed  CAS  Google Scholar 

  • Wang W, Li HL, Wang DX, Zhu X, Li SL, Yao GQ, Chen KS, Gu XE, Zhu SN (2012) Haloperidol prophylaxis decreases delirium incidence in elderly patients after noncardiac surgery: a randomized controlled trial*. Crit Care Med 40(3):731–739. doi:10.1097/CCM.0b013e3182376e4f

    Article  PubMed  CAS  Google Scholar 

  • Xia ZQ, Chen SQ, Yao X, Xie CB, Wen SH, Liu KX (2013) Clinical benefits of dexmedetomidine versus propofol in adult intensive care unit patients: a meta-analysis of randomized clinical trials. J Surg Res 185(2):833–843. doi:10.1016/j.jss.2013.06.062

    Article  CAS  PubMed  Google Scholar 

  • Zaslavsky A, Haile M, Kline R, Iospa A, Frempong-Boadu A, Bekker A (2012) Rivastigmine in the treatment of postoperative delirium: a pilot clinical trial. Int J Geriatr Psychiatry 27(9):986–988. doi:10.1002/gps.2801

    Article  PubMed  Google Scholar 

  • Zaubler TS, Murphy K, Rizzuto L, Santos R, Skotzko C, Giordano J, Bustami R, Inouye SK (2013) Quality improvement and cost savings with multicomponent delirium interventions: replication of the Hospital Elder Life Program in a community hospital. Psychosomatics 54(3):219–226. doi:10.1016/j.psym.2013.01.010

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Tufts University School of Medicine, Boston, MA, USA

    Walter J. Kilpatrick III & Benjamin Liptzin

  2. Baystate Medical Center, Springfield, MA, USA

    Walter J. Kilpatrick III & Benjamin Liptzin

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  1. Walter J. Kilpatrick III
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  2. Benjamin Liptzin
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  1. The Chinese University of Hong Kong, Tai Po, Hong Kong

    Helen Chiu

  2. Sunnybrook Research Institute, Toronto, Ontario, Canada

    Kenneth Shulman

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Kilpatrick, W.J., Liptzin, B. (2016). Delirium. In: Chiu, H., Shulman, K. (eds) Mental Health and Illness of the Elderly. Mental Health and Illness Worldwide. Springer, Singapore. https://doi.org/10.1007/978-981-10-0370-7_9-1

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