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There is very low quality evidence to show that a multicomponent intervention targeting three modifiable risk factors dehydration/nutrition, pain management, medication management with training showed: o significantly shorter duration of delirium in patients in the intervention group o no significant difference in the median length of stay in hospital There is moderate quality evidence to show that a multicomponent geriatric intervention based on targeting four modifiable risk factors orientation, dehydration/nutrition, early mobilisation, medication management with comprehensive geriatric assessment showed a: o significant number of patients recovered from delirium at 8 days in the intervention group; however, there is much uncertainty around this result o significant difference showing a decreased length of stay in the usual care group; o small significant improvement in the health related quality of life mental function, daily functioning, depression, vitality, and speech for the intervention group at discharge 344 DELIRIUM o borderline significant difference showing a lower level of cognitive impairment at 6 months for the intervention group o non significant difference in the number of patients discharged to long term care; there is much uncertainty around this result. There is very low quality evidence to show a multicomponent intervention targeting two modifiable risk factors orientation, early mobilisation with training, continuous nursing support and annual one week visits to a rehabilitation unit showed no significant difference in: o long term care stay over the duration of the study 3 years; there is much uncertainty around this result o mortality rates at 3 years 12. Instead the GDG drew on the principles of the multicomponent interventions and their clinical expertise to inform the recommendations. The GDG agreed treatment of delirium should comprise the following: initial management for all people with delirium, second line management for those who are distressed or are considered a risk to themselves or others, management for people whose symptoms do not resolve, either following initial or second line management.

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