What is delirium? Delirium is a mental state in which you are confused, disoriented, and not able to think or remember clearly. It usually starts suddenly. It is often temporary and treatable.There are three types of delirium:Hypoactive, where you are not active and seem sleepy, tired, or depressedHyperactive, where you are restless or agitatedMixed, where you change back and forth between being hypoactive and hyperactiveWhat causes delirium?There are many different problems that can cause delirium. Some of the more common causes includeAlcohol or drugs, either from intoxication or withdrawal. This includes a serious type of alcohol withdrawal syndrome called delirium tremens. It usually happens to people who stop drinking after years of alcohol abuse.Dehydration and electrolyte imbalancesDementiaHospitalization, especially in intensive careInfections, such as urinary tract infections, pneumonia, and the fluMedicines. This could be a side effect of a medicine, such as sedatives or opioids. Or it could be withdrawal after stopping a medicine.Metabolic disordersOrgan failure, such as kidney or liver failurePoisoningSerious illnessesSevere painSleep deprivationSurgeries, including reactions to anesthesiaWho is at risk for delirium?Certain factors put you at risk for delirium, includingBeing in a hospital or nursing homeDementiaHaving a serious illness or more than one illnessHaving an infectionOlder ageSurgeryTaking medicines that affect the mind or behaviorTaking high doses of pain medicines, such as opioidsWhat are the symptoms of delirium?The symptoms of delirium usually start suddenly, over a few hours or a few days. They often come and go. The most common symptoms includeChanges in alertness (usually more alert in the morning, less at night)Changing levels of consciousnessConfusionDisorganized thinking, talking in a way that doesn't make senseDisrupted sleep patterns, sleepinessEmotional changes: anger, agitation, depression, irritability, overexcitementHallucinations and delusionsIncontinenceMemory problems, especially with short-term memoryTrouble concentratingHow is delirium diagnosed?To make a diagnosis, the health care providerWill take a medical historyWill do physical and neurological examsWill do mental status testingMay do lab testsMay do diagnostic imaging testsDelirium and dementia have similar symptoms, so it can be hard to tell them apart. They can also occur together. Delirium starts suddenly and can cause hallucinations. The symptoms may get better or worse and can last for hours or weeks. On the other hand, dementia develops slowly and does not cause hallucinations. The symptoms are stable and may last for months or years. What are the treatments for delirium?Treatment of delirium focuses on the causes and symptoms of delirium. The first step is to identify the cause. Often, treating the cause will lead to a full recovery. The recovery may take some time - weeks or sometimes even months. In the meantime, there may be treatments to manage the symptoms, such asControlling the environment, which includes making sure that the room is quiet and well-lit, having clocks or calendars in view, and having family members aroundMedicines, including those that control aggression or agitation and pain relievers if there is painIf needed, making sure that the person has a hearing aid, glasses, or other devices for communicationCan delirium be prevented?Treating the conditions that can cause delirium may reduce the risk of getting it. Hospitals can help lower the risk of delirium by avoiding sedatives and making sure that the room is kept quiet, calm, and well-lit. It can also help to have family members around and to have the same staff members treat the person.
