Confusion and Delirium: Causes, Symptoms & Treatment

Confusion and Delirium: Causes, Symptoms & Treatment

Delirium is a form of confusion that develops when your brain function is disrupted by several illnesses, environmental factors, or other risk factors. Adults over 65 are more likely to have it. Due to treatment delays, this...

Delirium is a form of confusion that develops when your brain function is disrupted by several illnesses, environmental factors, or other risk factors. Adults over 65 are more likely to have it. Due to treatment delays, this disease is serious and may result in long-term or permanent issues. However, it's frequently avoidable.

Describe Delirium

Delirium is a variety of confusion that quickly worsens and impairs your awareness and ability to concentrate. It occurs when there is a general disruption in brain activity, typically as a result of several factors working together. Delirium is more prevalent in hospitals, long-term care facilities, and other medical environments, such as during extended hospital stays.

When in insanity, people frequently behave very differently from how they would normally. People who see a loved one in delirium frequently say or feel things like "That's not the person I know."

Experts used to believe that delirium was a comparatively minor and harmless problem. Today, they are aware that it is a serious issue that ought to be identified and avoided whenever feasible.

The frequency of insanity or Delirium

According to research, delirium affects 18% to 35% of patients who are admitted to a hospital for inpatient treatment. In an intensive care centre, delirium could affect up to 60% of the patients. The prevalence of delirium may be higher than data suggest, according to researchers.

Delirium can affect anyone, even though it is more common in older adults, particularly those over 65. That implies that, given the proper conditions, it can manifest in kids, teens, and young adults alike.

Are hysteria and dementia the same thing?

Dementia and delirium are not the same. Delirium has signs that "wax and wane," or get better and worse. The word "dementia" clarifies a gradual loss of mental ability.

However, given their many parallels, it's simple to mistake them for one another. You are more probable to undergo delirium if you retain dementia, and they can both occur together and combine. Delirium can also hasten the onset of dementia or worsen dementia that already exists.

Confusion occurs in both delirium and dementia, but there are some key distinctions:

How soon does it start to appear?

Delirium: Fast. Over a day or several, it manifests.

Dementia: Slowly. Before it becomes severe enough to be noticed, it may take years.

What takes place over time?

Delirium: It may come and go, improving or deteriorating from hour to hour.

Dementia: It progressively grows worse over time.

Is it avoidable?

Delirium: Yes, in as many as a third of instances.

Dementia: No.

Is it curable?

Delirium: particularly when the causes are treatable.

Dementia: However, some signs can be managed.

Will things improve?

Delirium: Yes, but without treatment, recovery will either be less probable or take longer.

Dementia: No. Permanent dementia exists.

What other names do people give to delirium?

Delirium has a history of being described in various ways, which is one of the main reasons why it frequently goes undiagnosed. This term is now very precisely used by healthcare professionals.

Other names for the insanity that are used now or have been in the past include:

  • Sundowning.
  • Very perplexing.
  • Psychosis following operation or the intensive care unit (ICU).
  • altered mental status (this phrase is appropriate in other situations, but it is not favoured for delirium).
  • Encephalopathy.


What signs or symptoms indicate delirium?

Delirium is a sign of a general disruption in mental function. That implies that insanity could manifest in a variety of ways. It's also important to keep in the sense that every person's indications will be distinctive. It may also change. Delirium frequently gets worse as night falls and gets better during the day, which is why it occasionally goes by the erroneous name of "sundowning."

Confusion is the primary symptom of delirium. That implies that you struggle with Concentrating or changing your focus when it's needed.

  • Considering and paying attention.
  • Remembering details, persons, events, etc.
  • Being conscious of your environment.
  • Accurately responding to questions about the time, date, and location.
  • Difficulty understanding what others are saying, speaking clearly, or responding to inquiries.
  • Difficulty understanding what you see, including difficulties recognizing things or your location.
  • Becoming more sensitive, frightened, or furious.

Delirium symptom patterns typically fell into one of three groups:

  • Hyperactive.
  • Hypoactive.
  • Mixed.
  • agitated insanity
  • Higher quantities of movement are present in this type of delirium. It is also understood as "excited delirium."

It may consist of:

  • Agitation.
  • aggression, hostility, or a reluctance to work together.
  • Mood changes.
  • poor quality slumber at night.
  • indications of psychosis, for example, hallucinations, and delusions.
  • loss of "filter," such as speaking inappropriately or using profanity in a way that is out of essence.

Hypnotic Delirium

Lower energy levels are present in this kind of delirium. Because doctors might mistake hypoactive delirium for fatigue or depression, it is more difficult to identify. Some signs are:

  • Speaking and facial gestures are lessened.
  • Decreased ability to adapt to environmental shifts.
  • Apathy and a loss of interest in what is going on in your environment.
  • Lethargy, sluggishness, or slowness of action.
  • Diminished enthusiasm for or involvement in your care.


The mixed variety of delirium combines traits from the hyperactive and hypoactive types, as the name implies.

 It typically exhibits one of the following characteristics:

  • Typical Level activity: You're still disoriented and not completely aware of your surroundings, but your activity level is about where it usually is for you.
  • Altering levels of activity: You alternate between overactive and hypoactive delirium. You might occasionally exhibit hyperactive signs before switching to hypoactive ones. Along with sleeping during the day and hyperactive signs like agitation or aggression at night, this can also occur.

What brings on delirium?

According to the study that is currently available, delirium is a complicated condition that doesn't have a single cause. Delirium, on the other hand, goes on when the "balancing act" between your functional proficiency, your functional limitations, and additional stressors is pushed too far. Your functional capability is on the one side. You can manage and bounce back from that much without feeling overburdened. The stresses are on the other side. Anything that makes it tougher for your body to function as it ought to qualify as that.

Stressors (causes and contributing factors)

The following are some potential triggers for delirium in a hospital setting:

You have certain disorders

Delirium is more likely to happen in senior patients. Multiple diseases, comprising cancer, illnesses (such as HIV, pneumonia, or COVID-19), sepsis, or stroke, can increase the likelihood that it will occur. A recent bone fracture increases a person's risk of getting delirium.

Those who have major surgery, particularly unscheduled urgent or emergency surgery, are much more likely to become delirious. It is also greatly increased by intubation or mechanical breathing.


Long-term inactivity, particularly when you're lying down, can have an impact on how your brain works. People who exercise regularly and take part in physical therapy have a lower risk of getting delirium, and delirium lasts less time if it does occur.


This phrase describes anything that is affixed to or implanted within your body and restricts your range of motion. This comprises oxygen tubes, bodily restraints, intravenous (IV, into your vein) lines, or Foley catheters (inserted appliances that empty urine directly from your bladder). A tether can even be a small gadget, like a patch that monitors your heart rate.

Pharmaceuticals You Consume

Even when taken as directed, some medications can increase your chance of developing delirium. Because of this, medical professionals frequently refrain from prescribing specific medications to patients 65 years of age and older or those who have a past of specific conditions. Taking more than five medications concurrently, or polypharmacy, also raises your chance.

Non-medical Substance Or Medication Use

Drug-induced delirium can be brought on by non-medical drug use, such as using pharmaceutical drugs in a manner other than recommended.

The Surroundings

Losing your body's ability to distinguish between day and night can significantly increase your risk of getting delirium. Natural lighting helps keep this ability. Your sleep-wake cycle may also be impacted by your perception of sound. An important factor in confusion is sleep deprivation.

not managing discomfort well. You run a higher risk of developing delirium if your pain is poorly or not at all controlled.

Stimulation (or lack of it)

Your body requires sensory input, and if you aren't receiving it, your brain may suffer. (especially as you get older). People who require eyeglasses or hearing aids are more likely to experience delirium, particularly if they aren't using these aids.

Determinants Of Death

 When a person is coming to the end of their life, delirium is a possibility, especially for those getting hospice or palliative care.

social exclusion. Delirium can get worse if a person is cut off or isolated from their loved ones. The treatment team values having your family on board because they can help you stay alert and conscious of your surroundings. People who are hosting family members have a reduced risk of developing delirium and/or experiencing it less frequently.

Risk Elements

Delirium may become more likely as a result of several risk factors. They consist of:

  • Age (especially 65 and older). Your risk of getting delirium is also several natural ageing processes.
  • Dementia (or other degenerative brain diseases). People who already have a condition that interferes with normal brain activity are more likely to experience delirium. Delirium can be caused by any age- or degenerative-related brain illness, or it can increase its likelihood to occur.
  • additional persistent medical problems
  • Your body is placed under stress by illnesses and conditions like heart disease and COPD. Delirium may develop more easily under that pressure. The stress and danger increase in proportion to the number of chronic conditions you have.
  • Mood disturbances. You're more likely to experience delirium if you've previously experienced mood disorders, especially melancholy.
  • Later in life, hearing and vision decline. You can learn about your surroundings with the assistance of your senses, particularly vision, and hearing. When those senses are lost, your brain is less able to process outside signals, which makes delirium more likely to occur.
  • illegal substance use and alcohol abuse. The chance of developing delirium is significantly increased by non-medical opioid and benzodiazepine drug use.
  • a prior episode of insanity. Delirium is more likely to recur in people who have previously experienced it.
  • Frailty. Your susceptibility to disease or harm is described by this medical word. As you age, your natural fragility rises. For this reason, while a fall for a young adult may not result in any injuries, a comparable fall for a person over 65 may be more hazardous. Similarly, bodily frailty makes it simpler to develop delirium, particularly as people age.

What side effects can insanity cause?

Delirium causes a generalised disruption in brain function, which can result in a variety of problems. They vary from minor and transient to serious and long-lasting.

 Among the complications to be aware of are:

  1. Dementia with a new onset or a worsening of an established case.
  2. Traumatic accidents and falls.
  3. long-term or persistent issues with cerebral function (cognitive impairment).
  4. freedom is lost due to an inability to take care of oneself.

Control and treatment

Is there a treatment for dizziness and a cure?

There is no particular medicine or therapy for delirium. Instead, healthcare professionals will address the root causes and influencing variables they can see. Delirium may improve with assistance with mobility and exercise or by removing tethers. While receiving therapy for the underlying causes of your delirium, monitoring and adjusting your medications can also help.

Disorientation And Medication

There are no drugs that specifically address dizziness. Instead, drugs address underlying issues or particular delirium signs. As a result, the treatments can differ significantly based on the causes of your symptoms and those of others. Antipsychotic drugs may be used to treat hyperactive delirium because they lessen agitation and aggressiveness.


Are delirious episodes avoidable?

Delirium is continually avoidable, but the majority of preventive phases should only be held out by medical specialists. The risk of delirium can be especially reduced, though, with the support of family, friends, and loved ones.