In geriatrics, delirium can be triggered by which factors?

• A. Infections, medications, dehydration, and stress
• B. Infections only
• C. Dehydration only
• D. Stress only

Answer: (A)

Delirium in older adults is usually triggered by several factors acting together; it’s an acute, fluctuating disturbance of attention and cognition that often results from multiple insults to the body. Infections are a common precipitator because they provoke inflammation and physiologic stress that can affect brain function. Medications play a big role as well—especially drugs with anticholinergic effects, sedatives, opioids, and the general impact of taking multiple drugs (polypharmacy) on an aging brain. Dehydration and electrolyte imbalances reduce cerebral perfusion and disrupt neuronal signaling, tipping the balance toward delirium. Stress from acute illness, surgery, or pain further challenges the brain’s ability to maintain stable cognition. Because delirium is typically multifactorial, a patient may have more than one trigger at the same time, and effective management involves identifying and addressing all contributing factors. Choices that list only one trigger miss the real, multifactorial nature of delirium in the elderly.