Delirium is associated with accelerated long-term cognitive decline and risk for disability, dementia, and death. These two empirically-based but seemingly contradictory statements underscore that delirium is poorly understood and that broad descriptive categories such as DSM diagnostic labels -- originally intended for actuarial and service planning purposes -- contribute little to (and perhaps detract from) our understanding of a complex, heterogeneous, and potentially devastating geriatric syndrome. In this presentation, we review existing literature and report on new results from the Successful Aging after Elective Surgery (SAGES) cohort that support that delirium is both transient / reversible and associated with long-term decline, and provide new research results that highlight the differential symptom and clinical outcome profiles of persons with delirium complicated by accelerated long-term cognitive decline. We provide evidence to support the new conceptualization of “complicated” delirium. This new conceptual model holds important implications for research, prevention, and clinical management.
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