TREATMENT STRATEGIES AND MULTIDISCIPLINARY APPROACH TO DELIRIUM IN ELDERLY PATIENTS

Abstract

Delirium is an acute, fluctuating neuropsychiatric syndrome with a high prevalence among hospitalized elderly patients; it is associated with increased mortality, functional and cognitive decline, and institutionalization. This integrative review synthesizes evidence regarding the prevention and treatment of the condition, highlighting that multicomponent non-pharmacological interventions constitute the most robust preventive strategy, reducing incidence by 27% to 54%. In the perioperative setting, modulating anesthetic depth (target BIS of 50) significantly reduces postoperative delirium, whereas the use of low-dose midazolam does not appear to increase this risk. For symptomatic control of the hyperactive subtype, quetiapine and haloperidol show comparable efficacy, although quetiapine offers a better profile regarding extrapyramidal effects and a reduction in ICU length of stay. It is concluded that multicomponent prevention and the rigorous control of precipitating factors remain the cornerstones of management, given that no pharmacological intervention has yet demonstrated the ability to shorten the course of the syndrome.