Pathophysiology
The higher risk of drug-related hospitalizations in older adults is mainly due to age-related pharmacokinetic and pharmacodynamic changes, polypharmacy, and chronic conditions [PMID:23446784].
Epidemiology
Older adults are about four to seven times more likely than younger persons to experience adverse drug events (ADEs) causing hospitalization, with a prevalence as high as 31% [PMID:23446784].
Medications are responsible for up to 39% of delirium cases in the elderly, highlighting the significant role of pharmacotherapy in this population [PMID:21913739].
Clinical Presentation
Common drugs causing emergency hospitalizations in older adults include central nervous system agents, which can manifest as delirium among other serious adverse effects [PMID:23446784].
Evaluation of delirium should include a thorough medication history, focusing on recent initiation, discontinuation, or dosage adjustments of medications [PMID:21913739].
Management
Haloperidol prophylaxis did not reduce the occurrence of delirium but decreased its severity and duration. In contrast, olanzapine and risperidone were associated with a reduced incidence of delirium compared to placebo [PMID:21913739].
References
1 Salvi F, Marchetti A, D'Angelo F, Boemi M, Lattanzio F, Cherubini A. Adverse drug events as a cause of hospitalization in older adults. Drug safety 2012. link 2 Catic AG. Identification and management of in-hospital drug-induced delirium in older patients. Drugs & aging 2011. link
2 papers cited of 3 indexed.