Taking Charge | Good Medical Care for the Elderly and How To Get It

Appendix D

Risk Factors for Delirium

The following are risk factors predisposing the elderly to delirium. Check each of the following factors that applies to your loved one and update this form often. If your loved one has a sudden change in cognition, review this appendix with her nurse and physician to help diagnose delirium.

Medications:

The following kinds of medications can cause delirium. How many of them are prescribed for your loved one?

	Antipsychotics
	Anxiolytics
	Antidepressants
	Digitalis glycosides
	Antiarrhythmics
	Calcium channel blockers
	Beta blockers
	H2 antagonists
	Narcotics
	Corticosteroids
	NSAIDs
	OTCs with anticholinergic properties

Conditions or Diseases:

The following conditions or diseases can predispose your loved one to delirium. Does your loved one have any of these?

Intoxication: (alcohol or medications)

Infection:

	Urinary tract infection
	Pneumonia
	Sepsis

Fluid or electrolyte disturbance:

	Dehydration
	Acid/base disturbance
	Derangements of calcium, potassium, sodium, or magnesium

Metabolic derangement:

	Hypoxia
	Hypoglycemia
	Hyperglycemia
	Hepatic or renal insufficiency
	Vitamin deficiencies
	Thyroid or parathyroid dysfunction
	Hypercortisolism
	Hypocortisolism

Cardiopulmonary disease:

	Myocardial infarction
	Congestive heart failure
	Cardiac arrhythmias
	Hypertensive encephalopathy
	Severe hypotension
	Pulmonary embolism
	Chronic obstructive pulmonary disease
	Anemia or acute blood loss

Cerebral disease or event:

	Stroke or recurrent temporary ischemic event
	Infection: meningitis, encephalitis, abscess, or encephalopathy occurring in acquired immunodeficiency syndrome
	Hematoma: subdural, epidural, or intracerebral
	Inflammatory disease: temporal arteritis or cerebral vasculitis
	Primary or secondary subarachnoid hemorrhage following trauma
	Nonconvulsive generalized status epilepticus

Miscellaneous events:

	Fecal impaction
	Urinary retention
	Hypothermia or hyperthermia
	Trauma
	Burns
	Fractures
	Surgery
	Environmental change, especially hospitalization

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