Thank you Daniel for sharing about Delirium and good luck for your research work. Keep on posting your research work on this site.

Hello Daniel, When I was a young researcher into falls at home - I was repeatedly informed of 'confused', 'delirious', 'demented' older people post admission to hospital with fractured femur and impaired mental state was often the case. But on visiting the same person some weeks later post discharge to own home no sign of confusion etc. was found. As with many commonplace words applied so readily to older people, spending time looking at the language and it's usage can be a worthwhile exercise in itself. When i spent 3 months in hospital before I had my daughter - I certainly lost touch with all sense of time in terms of knowing the days of the week - had I been 65 and over this might have been construed as some form of mental impairment!! It could be that the professional's love of labeling the observation to enable it to be measurable could have become more important than understanding the influence of the context. Good luck with your research.

Daniel, I'm interested in body movement/mobility in critically ill older adults, and I've pondered whether delirium is related to immobility. Causation is probably too srong a word, but I wonder if lack of body movement is isolating and, thus, disorienting, possibly contributing to delirium. Do you think it is reasonable to hypothesize that we could help prevent delirium with earlier mobilization of our ICU patients? Thank you.

Hello Daniel.

i think that the difference between demntia en delierium is only known the last few years. That is with the personal who took care of the elderly.Only sinds 10 jears we on the geriatric department of the umcutrecht we developt the DOS ( delier observation scale) to be used bij the nursing personal. And stil i think that the problem is onderastemated especially on chirurgical departments in hospitals . that is why medical treaments is dosed higher with postoperative delirium than it would be if you expect it and treat it pre operative Good luck with your research

Daniel, I think ageism plays a part, also. There remains a bias toward older adults as "easily confused," "pleasantly confused (the most offensive term, I think)", and similar terms. In my ICU practice, I hear these terms all the time from all types of health care professionals, and even assumptions of dementia in perfectly functional, capable older adults.

Have you considered correlations with dementia protein in the blood, or mutations of APP, PS1, or PS2? Other than nutritional deficiencies, drug side effects/ interactions, and mitochondrial diseases...these others suggest possible neurologic angles that can be tested for.

Hello Jennifer,

Can you further elaborate on the dementia protein/ Mutations in delirium. It seems very interesting!

A simple blood test can be done to determine the presence of these. This is often done in cases to differentiate between alzheimers and dementia. Lisa Genova (PhD in neuroscience and writer for the National Alzheimer's Association) writes on this. Additionally, have you considered the electrolyte imbalances that most always illicit similar symptoms? I am curious if Flurizan and similar medicines are effective in limiting amyloid-beta 42 production. Presenilin-1 secretase releases normal amyloid-beta but when mutated, the release of amyloid-beta becomes unregulated. Genova explains the concepts in her book, Still Alice. Good luck....fascinating topic!

Hello Daniel and others: The American Delirium Society will hold its 3rd annual meeting in Indianapolis this June. The EDA and the ADS convene clinicians and researchers to discuss the latest trends.

Paula Trzepacz, MD

Daniel:

Delirium is a fascinating theme.

Now I´m advising to a student with his thesis of the Graduate Program of the Universidad Peruana Cayetano Heredia

"Associated factors to delirium in hospitalized elderly patients: a Case - Control Study".

Sincerely.

[email protected]

I found this important group.

ICU Delirium and Cognitive Impairment Study Group.

www.mc.vanderbilt.edu/icudelirium