Registered Nurses´ Association of Ontario
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Background
Delirium, dementia and depression are often unrecognized among the geriatric population, due to their complexity and multi-faceted nature. This lack of recognition impacts on the quality of life, morbidity and mortality of the older client. Enabling the nurse to recognize and provide timely screening for delirium, dementia and depression may result in improved outcomes for the client.
Delirium is a temporary disordered mental state, characterized by acute and sudden onset of cognitive impairment, disorientation, disturbances in attention, decline in level of consciousness or perceptual disturbance. A prevalent disorder, it is estimated that 14 to 80 percent of all elderly clients hospitalized for the treatment of acute physical illnesses experience an episode of delirium. Studies have shown a marked variability in the epidemiology of delirium results from the differences in study populations, diagnostic criteria, case finding and research techniques (Foreman, Wakefield, Culp & Milisen, 2001).
Dementia is a syndrome of progressive decline in multiple areas of cognitive function eventually leading to a significant inability to maintain occupational and social performance. The estimates of the prevalence of dementia range from 2.4 percent among persons aged 65-74 years, to 34.5 percent among those aged 85 and over (Loney, Chambers, Bennett, Roberts & Stratford, 1998). Research shows there are presently over 250,000 seniors with dementia in Canada, and it is estimated to rise to 778,000 by 2031 (Canadian Study on Health and Aging, 1994b; Patterson et al., 2001).
Depression is a syndrome comprised of a constellation of affective, cognitive and somatic or physiological manifestations in varying severity from mild to severe (Kurlowicz & NICHE Faculty, 1997; National Institute of Health Consensus Development Panel, 1992). Depressive symptoms occur in 15 to 20 percent of community-based elders requiring clinical attention and 37 percent of elders in primary care settings.
