[Delirium in the elderly - common and dangerous].

Delirium is an acute, fluctuating neurocognitive disorder characterized by disturbances in consciousness and attention. Unlike dementia, delirium has somatic causes and is reversible if the triggers are identified and treated. Elderly people are particularly at risk, especially those in hospitals or long-term care facilities.Its development is multifactorial. The threshold concept explains the interaction of predisposing factors such as age, dementia, multimorbidity, malnutrition, substance use, and triggering factors such as surgery, infections, pain, and immobilization. Early detection and risk minimization are important, such as promoting sleep, orientation, fluid intake, mobilization, and familiar caregivers. Screening should be carried out regularly for people at risk. The causes of infections, electrolyte imbalances, and fractures should also be clarified. The first measures taken are non-pharmacological, such as training, enhanced orientation, environmental design, sleep, mobilization, pain management, and family integration. Pharmacological measures have a purely symptomatic effect and may be useful in cases of hyperactive delirium with self-harm or harm to others. Interprofessional collaboration is always important for successful delirium management.