8 Clinical update on delirium

Delirium affects more than 20% of older people in the acute hospital. It is has multiple adverse outcomes including increased length of stay, loss of independence, and increased mortality. The importance of distress in delirium, affecting both patients and carers, has emerged as a core issue in the care of patients with delirium. Additionally, recent research has shown that delirium is associated with a higher risk of new onset dementia as well as acceleration of existing dementia. In this lecture the following topics will be covered: current diagnostic criteria for delirium; updates in understanding of terminology including appropriate use of the terms delirium and acute encephalopathy; epidemiology including the relationship between delirium and future dementia risk; a summary of current understanding of pathophysiology including delirium-dementia relationships; clinical care including detection (distinguishing between episodic and inpatient monitoring tools; treatment; prevention; future directions in clinical care and research.