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Delirium (formerly acute confusional state, an ambiguous term that is now discouraged) [1] is a specific state of acute confusion attributable to the direct physiological consequence of a medical condition, effects of a psychoactive substance, or multiple causes, which usually develops over the course of hours to days.
Delirium is most common in hospitalized patients, appearing in 18-35% of patients requiring hospital admission. [9] It is also a diagnosis which can be acquired during hospital stays, typically by elderly patients or those with risk factors of delirium.
The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) is a questionnaire that can be filled out by a relative or other supporter of an older person to determine whether that person has declined in cognitive functioning. The IQCODE is used as a screening test for dementia. If the person is found to have significant cognitive ...
The Abbreviated Mental Test score (AMTS) is a 10-point test for rapidly assessing elderly patients for the possibility of dementia.It was first used in 1972, [1] [2] and is now sometimes also used to assess for mental confusion (including delirium) and other cognitive impairments.
Sundowning, or sundown syndrome, [1] is a neurological phenomenon wherein people with delirium or some form of dementia experience increased confusion and restlessness beginning in the late afternoon and early evening.
More likely in the elderly with pre-existing declining mental functions, termed mild cognitive impairment (MCI). [13] MCI is a transitional zone between normal mental function and evident Alzheimer's disease or other forms of dementia. It is insidious, and seldom recognized, except in retrospect after affected persons are evidently demented.
In hospitals, the elderly face the very real problem of ageism. For example, doctors and nurses often mistake symptoms of delirium for normal elderly behavior. Delirium is a condition that has hyperactive and hypoactive stages. In the hypoactive stages, elderly patients can just seem like they are sleeping or irritable. [15]
The 4AT is designed to be used as a delirium detection tool in general clinical settings, inpatient hospital settings outside of the Intensive Care Unit (ICU), or in the community. The 4AT is intended to be used by healthcare practitioners without the need for special training, and it takes around two minutes to complete. [ 4 ]