# Delirium management in perioperative geriatric services: a narrative review of non-pharmaceutical strategies

## TL;DR

This paper reviews non-drug strategies to manage delirium in elderly patients before and after surgery, aiming to improve recovery and reduce complications.

## Contribution

The paper emphasizes integrating cognitive assessments and non-pharmaceutical protocols into perioperative care for elderly patients.

## Key findings

- Postoperative delirium affects up to 70% of elderly patients and 90% with neurodegenerative diseases.
- Non-pharmaceutical strategies can reduce delirium risks and improve patient outcomes.
- Early cognitive assessments help in identifying and managing delirium effectively.

## Abstract

Delirium, a common complication in elderly surgical patients, poses significant challenges in perioperative care. Perioperative geriatric services (PGS) aim at managing comorbidities, postoperative complications, and initiating early recovery of mobility to enhance elderly patients’ prognosis in the perioperative period. Studies have shown that patients with preoperative cognitive disorders are at a significantly increased risk of postoperative delirium. While postoperative delirium affects up to 70% of people over 60 and 90% of people with neurodegenerative diseases, it remains underdiagnosed in many cases. Postoperative delirium can lead to functional decline, prolonged hospitalization, increased healthcare costs, cognitive impairment, and psychological malaise. This article briefly summarizes the literature on delirium, its risk factors, and its non-pharmaceutical management strategies within the perioperative period. It highlights the importance of integrating cognitive and psychological assessments into perioperative care protocols to provide baseline data, improve patient outcomes, reduce hospital stays, and minimize complications associated with delirium. By embracing evidence-based delirium management protocols, healthcare professionals can better identify and manage delirium, ultimately improving the quality of care for elderly surgical patients, which would also benefit healthcare staff and healthcare institutions.