title: Polypharmacy and Delirium in Critically Ill Older Adults: Recognition and Prevention.
abstract: Among older adults, polypharmacy is a sequelae of admission to the intensive care unit and is associated with increased medication-associated adverse events, drug interactions, and health care costs. Delirium is prevalent in critically ill geriatric patients and medications remain an underappreciated modifiable risk for delirium in this setting. This article reviews the literature on polypharmacy and delirium, with a focus on highlighting the relationships between polypharmacy and delirium in critically ill, older adults. Discussed are clinician strategies on how to recognize and reduce medication-associated delirium and recommendations that help prevent polypharmacy when interventions to reduce the burden of delirium in this vulnerable population are being formulated.
authors.affiliation: Division of Pulmonary, Critical Care, and Sleep Medicine, Tufts Medical Center, 200 Washington Street, Boston, MA 02111, USA.
authors.forename: Erik
authors.initials: E
authors.lastname: Garpestad
authors.affiliation: Division of Pulmonary, Critical Care, and Sleep Medicine, Tufts Medical Center, 200 Washington Street, Boston, MA 02111, USA; School of Pharmacy, Northeastern University, 360 Huntington Avenue 140TF RD218F, Boston, MA 02115, USA. Electronic address: j.devlin@neu.edu.
authors.forename: John W
authors.initials: JW
authors.lastname: Devlin
mesh_terms: D000368:Aged; D016638:Critical Illness / Q000453:epidemiology / Q000628:therapy*; D003693:Delirium / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control; D014943:Global Health; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D019338:Polypharmacy; D012307:Risk Factors
keywords: Antipsychotic agents; Benzodiazepine; Delirium; Intensive care; Medications; Older adults; Polypharmacy; Prevention