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8 Clinical update on delirium
  1. Alasdair MJ MacLullich
  1. Professor of Geriatric Medicine, Usher Institute, University of Edinburgh. Following undergraduate medical training at the University of Edinburgh, including an intercalated BSc in Psychology, Alasdair MaLullich completed general medical training and went on to do a PD on glucocorticoids and cognitive ageing. He was Clinical Lecturer in Geriatric Medicine from 2000-2005 then MRC Clinician Scientist Fellow from 2005-2009, and was appointed Professor of Geriatric Medicine in 2009. His main research interests are the clinical assessment, neuropsychology, and pathophysiology of delirium. He also has interests in dementia, frailty, and hip fracture research. He is the main author of the 4AT delirium assessment tool. He co-founded the European Delirium Association in 2006 and the Scottish Delirium Association in 2011, Alasdair MaLullich is active clinically, working in acute geriatric medicine and acute orthogeriatrics. He co-chaired the committee which produced the Scottish Intercollegiate Guidelines Network guidelines on delirium, published in 2019. He is Chair of the Scottish Hip Fracture Audit Steering Group


Delirium affects more than 20% of older people in the acute hospital. It is has multiple adverse outcomes including increased length of stay, loss of independence, and increased mortality. The importance of distress in delirium, affecting both patients and carers, has emerged as a core issue in the care of patients with delirium. Additionally, recent research has shown that delirium is associated with a higher risk of new onset dementia as well as acceleration of existing dementia.

In this lecture the following topics will be covered: current diagnostic criteria for delirium; updates in understanding of terminology including appropriate use of the terms delirium and acute encephalopathy; epidemiology including the relationship between delirium and future dementia risk; a summary of current understanding of pathophysiology including delirium-dementia relationships; clinical care including detection (distinguishing between episodic and inpatient monitoring tools; treatment; prevention; future directions in clinical care and research.

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