Many recent studies have determined the clinical features and outcome
of delirium in elderly subjects. The diagnosis rests on the presence o
f the three main clinical symptoms: impaired alertness, sleep-wake cyc
le inversion, and fluctuations in neuropsychological symptoms over tim
e. Important steps are evaluation of risk factors (i.e., prior neurolo
gical disorders and neurosensory deficits) and precipitating events (m
ainly organic diseases). The leading causes are infectious, metabolic,
and cardiovascular diseases. Although recovery is the rule, a history
of delirium is associated with a twofold to threefold increase in mor
tality and with an increased risk of loss of self-sufficiency. Managem
ent by a geriatric team should be provided immediately, with the main
goals of detecting precipitating events and preventing complications.