Delirium in the elderly viva

Frame. Acute behavioural change in the elderly is delirium until a precipitant work-up is complete — confirm the precipitant list against local delirium protocol. Delirium is a common serious syndrome, usually triggered by illness or drugs, and remains underdetected.^[2]

Screens. 4AT rapid screen (Arousal, Attention, Abbreviated Mental Test-4, Acute change) designed for routine use; CAM diagnostic features enabling non-psychiatric clinicians to detect delirium quickly in high-risk settings.^[1][2] Collateral is mandatory.

Differential. Dementia is the leading risk factor for delirium, and delirium is an independent risk factor for subsequent dementia — confirm bedside discriminators against local delirium teaching.^[3]

Precipitants and management. Infection, drugs, withdrawal, electrolytes, retention/impaction, intracranial event, cardiopulmonary/metabolic causes — treat the cause with de-escalation and pharmacological choices per local delirium protocol. CT if indicated by trauma/neurology/anticoagulation — not automatically, and not after unnecessary deep sedation.^[2]