Treatment of delirium requires identifying and managing the underlying causes, managing delirium symptoms, and reducing the risk of complications. In some cases, temporary or symptomatic treatments are used to comfort the person or to facilitate other care (e.g. preventing people from pulling out a breathing tube). Antipsychotics are not supported for the treatment or prevention of delirium among those who are in hospital; however they will be used in cases where a patient has a history of anxiety, hallucinations or if they are a danger to themselves or others. When delirium is caused by alcohol or sedative hypnotic withdrawal, benzodiazepines are typically used as a treatment. There is evidence that the risk of delirium in hospitalized people can be reduced by systematic good general care. In a DSM assessment, delirium was found to affect 14–24% of all hospitalized individuals, with an overall prevalence for the general population as 1–2%, increasing with age, reaching 14% of adults over age 85. Among older adults, delirium was found to occur in 15–53% of those post-surgery, 70–87% of those in the ICU, and in up to 60% of those in nursing homes or post-acute care settings. Among those requiring critical care, delirium is a risk for death within the next year. Definition
In common usage, delirium is often used to refer to drowsiness, disorientation, and hallucination. In medical terminology, however, acute disturbance in consciousness/attention and a number of different cognitive symptoms are the core features of delirium.
In prospective studies, people hospitalised from any cause appear to be at greater risk of dementia and faster trajectories of cognitive decline, but these studies did not specifically look at delirium. In the only population-based prospective study of delirium, older persons had an eight-fold increase in dementia and faster cognitive decline. The same association is also evident in persons already diagnosed with Alzheimers dementia.Recent long-term studies showed that many patients still meet criteria for delirium for a prolonged period after hospital discharge, with up to 21% of patients showing persistent delirium at 6 months post-discharge. Dementia in ICU survivors
Dementia is supposed to be an entity that continues to decline, such as Alzheimers disease. Another way of looking at dementia, however, is not strictly based on the decline component, but on the degree of memory and executive function problems. It is now known, for example, that between 50% and 70% of ICU patients have tremendous problems with ongoing brain dysfunction similar to those experienced by Alzheimers or TBI (traumatic brain injury) patients, leaving many ICU survivors permanently disabled. This is a distressing personal and public health problem and is getting an increasing amount of scrutiny in ongoing investigations.The implications of such an "acquired dementia-like illness" can profoundly debilitate a persons livelihood level, often dismantling his/her life in practical ways like impairing ones ability to find a car in a parking lot, complete shopping lists, or perform job-related tasks done previously for years.