neurologic disorders
Delirium
Pathophysiology of Delirium
Mechanisms are not fully understood but may involve Reversible impairment of cerebral oxidative metabolism Multiple neurotransmitter abnormalities, especially cholinergic deficiency Generation of inflammatory markers, including C-reactive protein, interleukin-1 beta and 6, and tumor necrosis factor–alpha Stress of any kind upregulates sympathetic tone and downregulates parasympathetic tone, impairing cholinergic function and thus contributing to delirium. Older people are particularly vulnerable to reduced cholinergic transmission, increasing their risk of delirium. Regardless of the cause, the cerebral hemispheres or arousal mechanisms of the thalamus and brain stem reticular activating system become impaired. 