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Delirium in the elderly: A silent cry for help.


Deana  V. Santos,
Joel Eleazar

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Publication Information

Publication Type
Publication Sub Type
Journal Article, Original
Philippine Journal of Internal Medicine
Publication Date
July-August 2000


BACKGROUND: The incidence of delirium according to foreign researches ranges from 40 percent-60 percent. There are no local researches regarding the incidence of this particular disorder among Filipino elderly. The consequence of the failure of medical health practitioners to Identify and manage the etiology connotes a serious threat and often than not morbidity/mortality.

OBJECTIVES: This study aims to determine the incidence of delirium among hospitalized elderly patients at St. Lukes Medical Centre Geriatric Ward and to determine the risk factors in the development of delirium in this population.

METHODOLOGY: This is a prospective, descriptive study on the incidence of delirium among hospitalized elderly patients at Geriatric Centre. Thirty five (35) older patients admitted consecutively at Geriatric Centre were included in the study. Each subject underwent a thorough physical and mental examination via structured and unstructured interviews by the geriatrician investigator. All patients examined were then referred to Psychiatrist-investigator for further evaluation. All cases were discussed to arrive at diagnosis.

RESULTS: The results revealed that 31.4 percent of the total population developed delirium during their hospital stay. Women (63 percent) outnumbered men (36 percent) in terms of the incidence of delirium. The old-old (80-89 years old and above) (55.5 percent) were most commonly afflicted by the disorder. Impairment in activities of daily living (ADL) was another risk factor in the development of delirium. Urine incontinent patients were more prone to delirium (36.4 percent). The most common etiologies identified in the subjects were infectious disorder (63.6 percent), metabolic disorder (36.4 percent), sensory disturbance (27.3 percent) and electrolyte disturbance (18.2 percent). Dementia stricken patients developed delirium at a higher rate (54.5 percent) compared to those without dementia. It was noted that those subjects with delirium had a longer hospital stay (average of 12.8 days) compared to the no n- delirious group (average of 7.5 days). Those diagnosed to suffer from delirium had a higher mortality rate at 27 percent. Majority (approximately 55 percent) presented with atypical type of delirium or the "Silent Delirium" which is very much apart from the adult type of delirium. The study likewise bolstered the Importance of a screening instrument such as Folstein Mini-Mental State Examination (MMSE) as an important armament in delirium identification. Delirium is a common disorder in the elderly population which merits urgent attention. It is a life threatening medical condition that needs immediate medical help.

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