Delirium in elderly: Battling a silent killer in the Indian context

Abstract

Delirium is considered a manifestation of acute brain failure that usually has an acute onset, fluctuating course, and is often associated with multitude of negative outcomes. It is usually seen in medical-surgical patients, with very high prevalence rates among those on mechanical ventilation. It is often undiagnosed and undertreated. In developed countries, delirium is usually managed by multidisciplinary teams and the focus is on both prevention and management of delirium. In contrast to the developed countries, in India, physicians–surgeons have a negative attitude toward delirium and due to which not only it is underdiagnosed and undertreated but also mismanaged, and mental health professionals are not consulted. The research on delirium in India is also limited. The psychiatrists when involved in the care of patients with delirium also mainly focus on using pharmacological agents, with relatively lesser emphasis on the use of nonpharmacological measures. Further, in their encounter with specialists from other specialties, psychiatrists pay little attention to discussing the diagnosis of delirium and its management. There is a need to have an attitudinal change both at the level of the physicians–surgeons and psychiatrists in terms of clinical practice and research on delirium in the Indian context.