Inouye, SharonWestendorp, Rudi GJSaczynski, Jane S2015-03-162014Inouye, Sharon K, Rudi GJ Westendorp, and Jane S Saczynski. 2014. “Delirium in Elderly People.” The Lancet 383 (9920) (March): 911–922. doi:10.1016/s0140-6736(13)60688-1.0140-6736http://nrs.harvard.edu/urn-3:HUL.InstRepos:14196632Delirium is an acute disorder of attention and cognition in elderly people (ie, those aged 65 years or older) that is common, serious, costly, under-recognised, and often fatal. A formal cognitive assessment and history of acute onset of symptoms are necessary for diagnosis. In view of the complex multifactorial causes of delirium, multicomponent non-pharmacological risk factor approaches are the most effective strategy for prevention. No convincing evidence shows that pharmacological prevention or treatment is effective. Drug reduction for sedation and analgesia and non-pharmacological approaches are recommended. Delirium offers opportunities to elucidate brain pathophysiology—it serves both as a marker of brain vulnerability with decreased reserve and as a potential mechanism for permanent cognitive damage. As a potent indicator of patients' safety, delirium provides a target for system-wide process improvements. Public health priorities include improvements in coding, reimbursement from insurers, and research funding, and widespread education for clinicians and the public about the importance of delirium.en-USJournal Article2014-12-20Inouye SK, Westendorp RGJ, Saczynski J2015-03-1610.1016/S0140-6736(13)60688-1