How is delirium prevented?

Updated: Sep 19, 2018
  • Author: Richard D Shin, MD; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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To date, few clinical studies have been published on preventing delirium; nevertheless, they have already indicated that around 30% to 40% of delirium episodes are preventable. Immobility, using physical constraints, using bowl catheter, malnutrition, psychadelics, some types of drugs, associated diseases, and dehydration in the individual can cause delirium symptoms. Old age, severe illness, dementia, physical frailty, infection and/or dehydration, vision impairments, drug interference caused by polypharmacy, surgery, and excessive use of alcohol are among other risk factors for delirium.

Yale Clinical Trial was the first controlled clinical trial that showed there are other non-pharmacological ways to prevent delirium in geriatric patients. This intervention included employing a standardized protocol on taking medical measures to eliminate or reduce the 6 risk factors of delirium in individuals older than 70 years. The 6 delirium risk factors in this study were cognitive impairment, sleep deprivation, immobility, visual impairments, hearing impairment and dehydration. The results of this study showed that delirium symptoms were 9.9% in intervention group in comparison with 15% in the usual-care group. The total number of delirium and the total number of its episodes showed a significant decrease in the intervention group. This intervention was associated with considerable improvement in the degree of cognitive impairment manifested in patients with cognitive impairment at admission as well as significant reduction in the rate of use of sleep medications in all patients in the intervention group. [18]

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