Postoperative delirium in the elderly

Postoperative delirium is an acute brain failure syndrome. It is a manifestation of complex interactions between the patient’s intrinsic neural reserve/compensation, disease processes (systemic versus localised), medical/surgical therapies, and the health care environment. Older age, comorbid neurodegenerative disease and the use of anticholinergic drugs predispose to more severe and prolonged delirium, with neurodegeneration as a consequence. There is an associated 30-40% one-year mortality following an episode of delirium in the older person.