Case Management of Delirium in Patients with Major Neurocognitive Disorders
Authors:   Clinical Neuroscience Department, University of Medicine and Pharmacy ”Carol Davila” Bucharest, Romania
Psychiatry Department, ”Dr. Carol Davila” University Emergency Central Military Hospital, Bucharest, Romania, Vasiliu Octavian , Panea Cristina A. ,   Clinical Neuroscience Department, University of Medicine and Pharmacy ”Carol Davila” Bucharest, Romania
Department of Neurology, Elias Emergency University Hospital, Bucharest, Romania, Mangalagiu Andrei G. ,   Clinical Neuroscience Department, University of Medicine and Pharmacy ”Carol Davila” Bucharest, Romania
Psychiatry Department, ”Dr. Carol Davila” University Emergency Central Military Hospital, Bucharest, Romania, Petrescu Bogdan M. ,   Clinical Neuroscience Department, University of Medicine and Pharmacy ”Carol Davila” Bucharest, Romania
Psychiatry Department, ”Dr. Carol Davila” University Emergency Central Military Hospital, Bucharest, Romania, Cândea Cristian A. ,   Psychiatry Department, ”Dr. Carol Davila” University Emergency Central Military Hospital, Bucharest, Romania, Manea Maria M. ,   Clinical Neuroscience Department, University of Medicine and Pharmacy ”Carol Davila” Bucharest, Romania
Department of Neurology, National Institute of Neurology and Neurovascular Diseases, Bucharest, Romania, Ciobanu Adela M. ,   Clinical Neuroscience Department, University of Medicine and Pharmacy ”Carol Davila” Bucharest, Romania
Prof. Dr. Al. Obregia Psychiatry Clinical Hospital, Bucharest, Romania, Sîrbu Carmen A. ,   Clinical Neuroscience Department, University of Medicine and Pharmacy ”Carol Davila” Bucharest, Romania
Neurology Department, Dr. Carol Davila” University Emergency Central Military Hospital, Bucharest, Romania, Mitrică Marian ,   Clinical Neuroscience Department, University of Medicine and Pharmacy ”Carol Davila” Bucharest, Romania
Neurosurgery Department, ”Dr. Carol Davila” University Emergency Central Military Hospital, Bucharest, Romania
Published: December 2024

Delirium is associated with lower quality of life, increased healthcare costs, longer hospitalizations, and worse prognosis when detected in patients who are already confronted with a severe and invalidating disease, like the major neurocognitive disorder (MND). In order to identify the most evidence-based interventions that could be included in case management for patients with both delirium and MND, this narrative review explored three electronic databases (Pubmed, Cochrane, and Web of Science/Clarivate) for primary and secondary sources dedicated to this topic. All papers published in English between the inception of each database and September 2024 were screened for relevant data on pharmacological and non-pharmacological therapies targeting delirium. The results supported the use of a multicomponent approach as the first line of treatment, mitigating the precipitating factors, and only as a second line, the use of pharmacological instruments. There is a lack of validated therapies targeting specifically the delirium superimposed on MND, most of the recommendations being extrapolated from studies with delirium in the general population or in elderly patients with different organic diseases. Further studies are required to investigate the specifics of delirium in patients with MND and potential strategies focused on neurobiological mechanisms instead of just clinical manifestations.