Page 1 of 2 Significance of General Practitioners and Nurses Diagnostic Skills in Managing Delirium in Elderly Patients Marzanna Derkacz-Jedynak, Andrzej Brodziak* and Alicja Różyk-Myrta Institute of Medical Sciences, University of Applied Sciences in Nysa, Poland Received Date: December 03, 2018 Published Date: December 12, 2018 Review Article Copyright © All rights are reserved by Andrzej Brodziak ISSN: 2641-1911 DOI: 10.33552/ANN.2018.02.000533 Archives in Neurology & Neuroscience *Corresponding author: Andrzej Brodziak, Institute of Medical Sciences, University of Applied Sciences in Nysa, Poland. Introduction Delirium consists of specific impairment of consciousness, which occurs in elderly patients due to the deterioration of adaptive abilities and adverse effects of various stimuli. Delirium worsens the outcome of care of patients, who are hospitalized, stay in different medical institutions or at home [1-6]. Healthcare providers should be familiar with the predisposing factors, diagnostic criteria and methods of managing delirium to be able to provide better prevention and treatment of the elderly. This will also lead to a reduction in burdens on health and social care providers [7,8]. Efficient and proper diagnosis of delirium in elderly patients is a challenge for general practitioners and nurses. The incidence of delirium may be underestimated due to diagnostic difficulties, the specificity of geriatric conditions and insufficient knowledge among healthcare providers [6]. Discussion Attempts to estimate the incidence of delirium lead to varying results, depending on what population is being analyzed. The incidence of delirium vary also depends on the diagnostic criteria which have been used [5,6]. In the general geriatric population, the incidence of delirium does not exceed 2%. According to the recent meta-analysis, the incidence of delirium in patients on geriatric and intern wards is 10-31% [6]. It is estimated that the incidence of delirium among patients in intensive care units, on cardiac surgery and orthopedics wards is respectively 82%, 46% and 51%. About 8-17% patients in emergency departments and 22% elderly patients of nursing homes were diagnosed with delirium [6]. Delirium is often confused with the behavioral and psychological symptoms of dementia (BPSD), depression and disorders secondary to “geriatric giants” or somatic illnesses. The fundamental characteristics of delirium are: a sudden beginning and impairment of cognitive functions such as fresh memory disturbances, confusion, or disorientation. Varying symptom intensity in time is typical. The diagnostic criteria of delirium are listed by the authors of the ICD-10 and DSM classifications. Differences in the sensitivity and This work is licensed under Creative Commons Attribution 4.0 License ANN.MS.ID.000533. Abstract Delirium consists of a specific impairment of consciousness which occurs in elderly patients due to the physiological deterioration of adaptive abilities and adverse effects of various stimuli. The incidence of delirium varies between reviewed populations and may be underestimated due to diagnostic difficulties, the specificity of geriatric conditions and insufficient knowledge among healthcare providers. Delirium is often confused with the behavioral and psychological symptoms of dementia (BPSD), depression and disorders secondary to “geriatric giants” or somatic illnesses. The diagnostic criteria of delirium are listed by the authors of ICD- 10 and DSM classifications. For general practitioners and nurses, proper diagnosis of delirium in elderly patients is a challenging process. Diagnosing delirium by non-qualified healthcare providers is facilitated by numerous psychometric and specialist tools and scales. The most common are: CAM – the Confusion Assessment Method, MDAS – the Memorial Delirium Assessment Scale; DOSS – the Delirium Observation Screening Scale and the recently verified tool 4AT–the rapid assessment test for delirium. Proper diagnosis of delirium warrants optimization of care and stress reduction by formal and informal caregivers. Keywords: Delirium; Dementia; Management of delirium; Assessment tools for delirium