Causes & Effects of Delirium

Learn About Delirium

Delirium is a neurocognitive condition whose symptoms include difficulty focusing or directing attention along with other disturbances such as disorientation, language difficulties, or memory problems. Delirium symptoms can last hours or days, and the disorder is often easy to recognize due to the dramatic change in an individual’s ability to function when he or she is in the midst of delirium. Individuals who are experiencing this condition may have poor awareness of surroundings, poor perception of self, may feel disoriented, or may be unable to speak or understand information.

It is very important to seek treatment for delirium as soon as symptoms begin. This disorder may be a symptom of a larger problem that requires immediate attention. These symptoms may also be caused by exposure to a toxic substance, brain injury, medication reaction, substance use, or other concerning or life-threatening conditions.

Delirium Statistics

Delirium is often diagnosed in senior citizens. During a given year, 1-2% of the population will be diagnosed with this condition. Nearly 14% of older adults (over age 85) will at some point suffer from episodes of delirium. In fact, 14-24% of hospital admissions among seniors are a result of delirium-related symptoms. The likelihood of delirium increases after surgery, as 15-33% of seniors are diagnosed with this disorder following a surgery, and 70-87% of seniors who have this disorder need intensive care hospitalization.

Causes and Risk Factors of Delirium

A number of environmental and genetic factors influence the onset of delirium. Some individuals may be more prone to this disorder due to age or health condition. Overall, many cases of delirium are influenced by the following:

Genetic: Family histories of neurocognitive disorders, such as vascular neurocognitive disease or Alzheimer’s disease, may make an individual more prone to delirium. Some medical conditions that are inherited may also lead to a delirium episode.

Environmental: Ingesting toxins, medicines, and drugs or alcohol may lead to delirium. In some cases, individuals may accidentally or purposefully ingest or breathe substances that alter mood and mental capacity.

Risk Factors:

• Older age
• Terminal or chronic illness
• Malnutrition
• High fever or infection
• Substance use
• Use of certain medicines or substances

Signs and Symptoms of Delirium

The symptoms of delirium are usually easily observable by others, though the cause of the delirium may impact the way the delirium manifests. All of these symptoms indicate a need for immediate medical attention.

Behavioral symptoms:

• Aggressive or hostile behavior
• Wandering aimlessly
• Refusal of medical care
• Hyperactivity, restlessness, or agitation
• Verbal or physical aggression
• Slowed movements or distant, unfocused gaze

Physical symptoms:

• Inability to sleep or stay asleep
• Changes in energy levels

Cognitive symptoms:

• Delusions
• Hallucinations
• Inability to sustain attention or focus on tasks
• Difficulty with reading, writing, or learning
• Disorientation
• Speech difficulties
• Memory problems
• Lack of awareness of person, place, or things

Psychosocial symptoms:

• Feelings of anxiety, apprehension, or worry
• Listlessness or apathy
• Euphoric mood swings
• Restlessness
• Irritability
• Anger or sudden rage
• Sudden changes in mood
• Feelings of fear

Effects of Delirium

Delirium comes with the potential for many negative consequences, including:

• Increased need for nursing home placement
• Increased need for overnight hospitalization
• Reduced cognitive functioning
• Trouble recovering from surgery
• Worsening physical conditions, or onset of new conditions
• Higher risk of severe illness or death

Co-Occurring Disorders

When an individual suffers from delirium, it is often a result of the consumption of a substance, another underlying medical condition, or exposure to a toxin. The individual’s environment, medical history, and substance use history all contribute to delirium symptoms. It is important to assess for:

• Substance use
• Other neurocognitive disorders
• Medication reactions or overdoses
• Physical illness