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      Delirium in elderly people

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      The Lancet
      Elsevier BV

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          Abstract

          Delirium is an acute disorder of attention and cognition in elderly people (ie, those aged 65 years or older) that is common, serious, costly, under-recognised, and often fatal. A formal cognitive assessment and history of acute onset of symptoms are necessary for diagnosis. In view of the complex multifactorial causes of delirium, multicomponent non-pharmacological risk factor approaches are the most effective strategy for prevention. No convincing evidence shows that pharmacological prevention or treatment is effective. Drug reduction for sedation and analgesia and non-pharmacological approaches are recommended. Delirium offers opportunities to elucidate brain pathophysiology--it serves both as a marker of brain vulnerability with decreased reserve and as a potential mechanism for permanent cognitive damage. As a potent indicator of patients' safety, delirium provides a target for system-wide process improvements. Public health priorities include improvements in coding, reimbursement from insurers, and research funding, and widespread education for clinicians and the public about the importance of delirium. Copyright © 2014 Elsevier Ltd. All rights reserved.

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          Author and article information

          Journal
          The Lancet
          The Lancet
          Elsevier BV
          01406736
          March 2014
          March 2014
          : 383
          : 9920
          : 911-922
          Article
          10.1016/S0140-6736(13)60688-1
          4120864
          23992774
          4ab88b15-d907-4533-91cc-97e813878b9d
          © 2014

          https://www.elsevier.com/tdm/userlicense/1.0/

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