The causes, symptoms, and management of delirium

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As we age, our bodies undergo numerous changes, and our cognitive health becomes increasingly important. Delirium is a common yet often overlooked condition that affects a significant number of elderly individuals. In this blog article, we will explore the various aspects of delirium in elderly people, including its causes, symptoms, and management strategies.


What is delirium?

Delirium is a medical condition characterized by an acute disturbance in mental function, typically accompanied by a fluctuating course. It is prevalent among elderly individuals due to various physiological and environmental factors. Delirium can occur suddenly, leading to confusion, disorientation, and changes in perception, attention, and thinking abilities. It is typically caused by underlying medical conditions, medications, surgery, or other factors. Delirium is reversible once the underlying cause is addressed.
A confused elderly, prostate problems, schizophrenia

Delirium vs dementia

Delirium is not the same as dementia. While both conditions can affect cognitive function, they are distinct in their characteristics and causes.


Dementia is a chronic and progressive condition that primarily affects memory, thinking, and behaviour. It is caused by brain damage or degeneration, most commonly seen in conditions such as Alzheimer’s disease. Dementia is a long-term condition that worsens over time and has no known cure, although management and support can help improve quality of life.


While delirium and dementia may share some similar symptoms, such as confusion and disorientation, their underlying causes and treatment approaches are different. It is important to differentiate between the two to provide appropriate care and interventions for individuals affected by these conditions.


Causes of delirium in the elderly

  1. Underlying medical conditions
    Delirium can arise as a result of medical conditions such as infections (urinary tract infections, pneumonia), dehydration, electrolyte imbalances, respiratory disorders, or adverse reactions to medications.
  2. Medications
    Certain medications, especially those with sedative properties or those affecting the central nervous system, can contribute to delirium in elderly individuals.
  3. Surgery and hospitalisation
    Elderly patients undergoing surgical procedures or those admitted to the hospital are at an increased risk of developing delirium due to factors such as anesthesia, pain medications, sleep disruption, and unfamiliar environments.
  4. Cognitive impairment
    Individuals with pre-existing cognitive impairments, such as dementia, are more susceptible to delirium.

Recognizing the symptoms of delirium

  1. Fluctuating mental status
    Delirium often presents as a rapid onset and fluctuation in cognitive function. The individual may appear disoriented, have difficulty focusing, or exhibit changes in their level of alertness.
  2. Disorganized thinking
    Delirium can cause confusion and disorientation, leading to difficulties in following conversations, remembering recent events, or expressing thoughts clearly.
  3. Perception changes
    Elderly individuals with delirium may experience hallucinations or have distorted perceptions of their surroundings, such as seeing or hearing things that aren’t present.
  4. Emotional disturbances
    Delirium can manifest as increased irritability, restlessness, anxiety, or apathy.
  5. Physical symptoms
    Some elderly individuals with delirium may exhibit physical symptoms such as sleep disturbances, tremors, poor coordination, or changes in appetite.

Management and treatment for delirium

  1. Identifying the underlying cause
    The first step in managing delirium is to determine and address the root cause. A thorough medical evaluation, including laboratory tests and imaging studies, can help identify contributing factors.
  2. Medication review
    A review of the individual’s medication regimen is essential to identify and adjust any medications that may be contributing to delirium.
  3. Creating a calm and supportive environment
    Providing a quiet, well-lit, and familiar environment can help reduce confusion and promote a sense of security. Ensuring regular sleep patterns, maintaining hydration, and addressing pain and discomfort are also crucial.
  4. Cognitive stimulation
    Engaging the individual in activities that promote mental stimulation, such as puzzles, reading, or conversations, can help improve cognitive function.
  5. Family and caregiver involvement
    Family members and caregivers play a vital role in the management of delirium by providing emotional support, monitoring changes in behaviour, and assisting with activities of daily living (ADL).

How to prevent delirium?

  1. Education and awareness
    Spreading awareness about delirium among healthcare professionals, caregivers, and family members can facilitate early recognition and intervention.
  2. Medication optimization
    Polypharmacy is a root cause of excessive medications. Healthcare providers should regularly review and adjust medication regimens, especially in elderly people.
Elderly people with dementia, delirium and regrets, future eldercare


Delirium in elderly people is a significant medical concern that requires attention and understanding. By recognizing the causes, symptoms, and management strategies outlined in this article, caregivers, healthcare professionals, and family members can work together to provide appropriate care and support for elderly individuals experiencing delirium.


Early identification, addressing underlying medical conditions, optimizing medications, creating a calm environment, and involving family and caregivers are key components of effective management. Additionally, preventive measures, such as education and medication optimisation, can help reduce the incidence of delirium in the elderly population.


With a comprehensive approach that combines medical intervention, environmental adjustments, and compassionate care, we can improve the well-being and quality of life for elderly individuals affected by delirium. It is our collective responsibility to raise awareness about this condition and ensure that our elderly loved ones receive the support they need to navigate this challenging condition.


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