As people get older and live longer they may suffer from many associated health problems. Delirium is one such occurrence that many elderly persons are known to be affected with. This may often disturb their regular living. Delirium in simple terms is sudden change in brain that may lead to emotional disturbance and confused state of mind.
Delirium causes impairment of thinking, sleeping, memorizing, perception, and attention. It may cause disturbance in vigilance and consciousness. Delirium may occur temporarily, but may fluctuate in severity during the day. There are multiple factors that may be responsible for delirium in elderly such as infection, pain, medications, and dehydration.
Treatment of delirium in old people consists of identifying and managing the medical condition. Patient also has to be provided with proper supportive care, prevention and treatment of complications.
Most Common Causes Of Delirium In Elderly
The exact pathology of delirium in elderly is not fully understood. It may occur as a result of acute illness, or problem with production of certain brain chemicals that control cognitive function of brain. Researchers have found too much of dopamine and reduced amount of acetylcholine in elderly individuals who suffer from delirium.
Here are some of the causes of delirium noted in old people:
- Fecal impaction and retention of urine: Retention of urine is common among elderly patients. Male patients may have retention due to enlarged prostate problem. While fecal impact may be due to reduced intestinal motility. Constipation can be caused due to improper intake of food and water among old people.
- Alcoholism and smoking are two causes that may cause delirium. This may be due to withdrawal symptoms of these two substances.
- Infection: Elderly individuals are prone to infections easily as they have reduced immunity. Person with lung infection, urinary tract infection, fever, is susceptible to become delirious.
- There are several medicines that may cause delirium in susceptible old individuals. Especially drugs taken for depression, anxiety, and other mood disorders, anticholinergic drugs, anti depressant medicines, sleep medicines, pain reducing medicines that contain narcotic content, anti Parkinson’s medicine, anti spasmodic, Quinolones, beta blockers are known to have delirium effect in susceptible old patients.
- Delirium is extremely common in hospitalized patients. Elderly patients in intensive care unit, post surgery ward, or those living in hospital for long period of time are have reduced cognitive awareness. Disorientation is commonly affects due to long stay in hospital, unfamiliar environment, frequent change of rooms etc.
- Electrolyte imbalance in old people is very common. This may be due to dehydration, poor intake of food containing essential salts etc. Electrolyte imbalance is frequent in elderly people suffering from diseases. They are prone to become delirious in such condition.
- Sleep deprivation in old people can cause disorientation and disturbed vigilance.
Signs And Symptoms Of Delirium In Elderly
The clinical features of delirium in old people can be of three varieties. It can be hypo-active, hyperactive and mixed variety. This may considered on their behavior, both physical as well as mental. Person with hyperactive form may be too restless, agitated. He may experience delusions and hallucinations.
Most elderly suffer from second variety; hypo active. Patient is lethargic and sleepy. His response to everything is very slow. His movements are also slow. Patients with mixed form have both the features of hyper and hypo-active delirium.
Here are common symptoms of delirium in old people:
- Acute in onset
- The condition is less than one month.
- Orientation is invariably impaired.
- Reduced clarity of thought and speech.
- Deteriorated short term memory.
- Impaired attention
- Patient is not fully alert.
- Disturbed sleep and wake cycle.
- Emotionally disturbed. He may be fearful, irritable, angry or depressed.
Treatment Options For Delirium In Elderly
Delirium is serious health problem with more prevalence in hospital settings and even at home. The first step is to identify delirium in old patients more than 60 years of age. Initially the signs and symptoms are subtle such as mild altered level of attention. A thorough medical history of old person regarding any chronic illness he is suffering from and medications he is taking must be confirmed.
If that is the case, the doctor may change certain medicines. If the cause is retention of urine, use of catheter to helps to empty the bladder. In case of impacted stool or constipation mild laxatives and enema will be useful to solve the problem.
Patient if healthy and mobile must practice mild exercise. At least he must walk for 10 to 20 minutes in open place or a garden. Treatment of infection is also essential to relieve delirium if that is the underlying cause. Full recovery is possible with treatment.