Delirium is the name given to a rapidly developing picture that affects a person's thinking, perception and behavior. It is a type of confusion that occurs when diseases, environmental conditions or various risk factors affect brain function. People with this condition may lose the concept of time and space, and may exhibit illogical or inappropriate verbal behavior. Although it is usually preventable, it can cause long-term or permanent problems with delays in treatment.
Since delirium, which is more common in people over 65 years of age, can show similar symptoms to dementia, the information provided by family members to the specialist (symptoms and behavioral characteristics of the person) is of great importance in its diagnosis.
What are the Symptoms of Delirium?
Delirium, which indicates a widespread impairment in brain activity, can have many possible symptoms. Therefore, symptoms may differ from person to person. While symptoms may fluctuate throughout the day, there may also be periods without any symptoms. Other symptoms of delirium, the main feature of which is confusion, are as follows:
- Problems with focus, distraction and indifference to surrounding events,
- Short-term memory loss and forgetting the recent past,
- Hallucinations and delusions,
- Unconsciousness (confusion),
- Disrupted sleep patterns and excessive daytime sleepiness,
- Anxiety, fear, restlessness and agitation,
- Uncontrolled crying and laughing,
- Disturbances in the concept of time and space,
- Physiological changes such as heart palpitations, high blood pressure, excessive sweating and abnormally high body temperature may occur.
What Causes Delirium?
Delirium is a disorder that occurs when signals in the brain cannot be transmitted or received properly. The disorder can have a single cause or multiple causes. Factors among the causes of delirium include:
- Some medications or their side effects,
- Symptoms of diseases,
- Urinary tract infection or dehydration
- Lack of sleep
- Organ failure (chronic lung disease, heart, kidney or liver failure),
- Sudden illnesses,
- Alcohol withdrawal after prolonged alcohol use,
- Low blood sugar levels,
- Time after surgery and complications of anesthesia.
What are the Types of Delirium?
Delirium is a condition that has several types with various characteristics. Some of the commonly described types of delirium are as follows:
Hypoactive Delirium
Decreased activity levels, inactivity and excessive sleepiness may occur. In such cases, the individual may withdraw and experience intense attention deficit.
Hyperactive Delirium
Hyperactive delirium is known as the easiest type to recognize. People with this condition can be restless, paranoid and aggressive. The person is also constantly on the move and does not want to sleep or lie down.
Mixed Delirium
In this mixed type, which includes both hyperactive and hypoactive symptoms, hyperactive symptoms may suddenly appear during inactivity, drowsiness or sleepiness.
What are the Risk Factors for Delirium?
This disease, which is generally more common in older people, can also be seen in young people. Some risk factors may increase the likelihood of developing delirium. Some of these risk factors are as follows:
- People over 70 years of age,
- Past history of delirium,
- Being immobilized in hospital for a long time due to a serious illness,
- Dehydration
- Depression or cognitive impairment,
- Chronic diseases,
- Complications of surgery or anesthesia,
- Sensory impairments such as vision or hearing,
- Excessive alcohol consumption or drug use.
How is Delirium Diagnosed?
Delirium is usuallydiagnosed through a medical evaluation after observation of symptoms and signs. Diagnostic methods for delirium are as follows:
- Medical history,
- Physical and neurological examinations,
- Urine and blood tests.
In addition, some imaging modalities such as MRI or computed tomography (CT) are used when a definitive diagnosis cannot be made with the above-mentioned methods. Early diagnosis and treatment of the disease is important to prevent complications.
How is delirium treated?
Delirium treatment is done by addressing the medical problems that cause this condition. First, the underlying cause is identified and symptoms are controlled. In some cases, many tests may be needed to find the cause. These tests may include blood tests, X-rays, brain imaging (such as MRI and CT scans) and electrocardiograms (ECGs).
Once the underlying cause has been identified, treatment is planned. Although there are no drugs that can directly treat the disease, the drugs used in treatment are aimed at alleviating and controlling the symptoms.
Can Delirium be Prevented?
In order to prevent delirium, it is necessary to recognize the risk factors that may trigger this condition and take appropriate measures. Some of the steps that can help reduce the risk and symptoms of delirium include
- Helping the patient develop a good sleep routine,
- Helping him/her to eat regularly and drink fluids,
- Supporting him/her to become active (sitting up or getting out of bed) as soon as possible,
- Setting a 24-hour clock and calendar that can be clearly seen by the patient.