Prevention, Diagnosis, and Management of Postoperative Delirium in Older Adults

Abstract

Approximately half of all operations performed in the United States are in patients greater than 65 years of age. The aging of the US population is expected to result in an increased need for surgical services among all subspecialties. Older adults represent a unique challenge to the surgeon, often presenting with multiple medical comorbidities and higher risk for postoperative complications. Despite the increasing need for surgical procedures among the elderly population, scant literature exists to address the specific perioperative needs of older adults. Among the many postoperative complications that result in increased morbidity, mortality, and health care costs, delirium represents a vital concern for surgeons. But research targeting prevention and management of postoperative delirium is limited. In this review, we highlight the available evidence for prevention and management of delirium. We also provide guidelines for optimal supportive care of the delirious surgery patient.