Looking Past Dementia Reveals Hidden Life Threats

Conclusion Acute delirium is commonly underdiagnosed, and can be masked by chronic alterations in cognition and mentation. Delirium has many causes, and can be assessed using the acronym DELIRIUM. The most common presentations suggesting delirium over dementia are short-term memory loss, rapid fluctuation in condition, acute alteration, and a condition present that may be responsible for delirium. Management includes searching for causes of acute alteration in mental status, negating environmental factors of delirium, and—only when necessary—reducing the patient’s threat to themselves or providers by using butyrophenones and mechanical restraints as appropriate. References 1. Vincent JL, Abraham E, Moore FA, et al (editors): Textbook of critical care. Elsevier: Philadelphia, pp. 3–10, 2017. 2. de la Cruz M, Fan J, Yennu S, et al. The frequency of missed delirium in patients referred to palliative care in a comprehensive cancer center. Support Care Cancer. 2015;23(8):2427–2433. 3. Fick DM, Steis MR, Waller JL, et al. Delirium superimposed on dementia is associated with prolonged length of stay and poor outcomes in hospitalized older adults. J Hosp Med. 2013;8(9):500–505. 4. Pisani M, Kong S, Kasl S, et al. Days of delirium are associated with 1-year mortality in an older intensive care population. Am J Respir Crit Care Med. 2009;180(11):1092–1097. 5. Golan DE, Armstrong EJ, Armstrong AW (editors): Principles of pharmacology: The pathophysiologic basis of drug the...
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