Evaluation of Delirium in Hospitalized Elderly Patients

INTRODUCTION: Delirium is one of the major Geriatric syndromes. It is usually multi-factorial in nature. It usually involves precipitating event in a vulnerable individual. Based on psychomotor activity delirium is classified as hypoactive, hyperactive, and mixed. In this study we have proposed to analyze predisposing and precipitating factors and delirium subtypes prevalent in hospitalized elderly patients. AIM OF THE STUDY: The primary objective of this cross sectional study in hospitalized elderly patients includes: 1. To study the etiology of delirium (predisposing factors and precipitating factors). 2. To study the delirium subtypes (hypoactive/ hyperactive/ mixed). MATERIALS AND METHODS: In this cross sectional study, patients with symptoms suggestive of delirium were screened after inclusion and exclusion criteria. Patients with definitive delirium diagnosed by CAM, severity assessed by DRS-R-98 were analyzed for predisposing and precipitating factors and delirium subtypes. 300 patients with delirium were analyzed in this study. RESULTS: In this study 60% of the delirious patients were male. Medical co-morbidities were seen in 86% of the patients as predisposing factors. Functional impairment and special sensory impairment were present in nearly 33% and 20% of the patients respectively as predisposing factors. Metabolic abnormalities were seen in 60% of the patients as precipitating factors followed by infections around 55%. Hypoactive delirium was the most prevalent subtype in our study seen in around 56% of the patients. CONCLUSION: Medical co-morbidities were the most common predisposing factor for delirium followed by functional impairment and malnutrition. The most common precipitating factor was metabolic abnormalities followed by infections. Most common subtype was hypoactive delirium in this study