Integrate Literature Review of Delirium on the Elders

Abstract

Delirium is a common problem for elderly hospitalized patients and those transferred from one place to another. The risk of delirium increases considerably with age. This article provides an integrated review of the literature on delirium in elderly patients; on the basis of this review, the characteristics of elderly delirium can be defined as follows: acute confusion with fluctuating changes in consciousness, orientation, attention, perceptions, emotion, thinking, sleeping patterns, and behaviors, which could develop and disappear in a short period. The related factors of elderly delirium include demographic and physical factors, as well as cognitive, functional, psychosocial, and other factors. Furthermore, scales for assessing elderly delirium include the short portable mental status questionnaire, mini-mental status examination, Confusion Assessment Method-ICU (CAM-ICU), delirium observation screening scale, NEECHAM Confusion Scale, Groningen Frailty Indicator, and Hasegawa’s Dementia Scale-Revised. Although the CAM-ICU has the least items and affords the fastest assessment, it lacks the items to measure orientation, perceptions, emotions, sleeping patterns, and behaviors, which are the characteristics of elderly delirium identified in the integrated literature review. Based on the literature review findings, the authors recommend that future studies should develop a comprehensive delirium assessment scale for elderly patients, including the related factors and defining characteristics, thus enabling health care professionals to care for and manage delirium problems effectively and efficiently. Moreover, the authors suggest developing an assessment scale to distinguish between the three problems (delirium, dementia, and depression) and reduce misdiagnosis rates, which would result in reduced hospitalization times, death rates, cost to the health care system, and patients being transferred to nursing homes.©