UK Stroke Forum 2025 | Recognizing delirium in patients who have had a stroke: screening and treatment strategies

I’m coming to you live from sunny Aberdeen at the UK Stroke Forum, where I had the privilege to be part of a session looking at cognition following stroke. And within that session, I focused on the syndrome of delirium. Now delirium is something that’s often forgotten in stroke, but we’ve shown that actually it’s incredibly common. Our research shows that it may affect up to one in four or perhaps even up to one in three people when they present with stroke and it’s important because of the effect that it has on outcomes. We know for a similar severity of stroke someone that has a stroke with delirium is more likely to die, is more likely to require institutional care and is much more likely to acquire dementia. The good news and the focus of the session was that there are easy ways to assess for delirium. It doesn’t need specialist neuropsychological input. There are short screening tests that work really well. And once delirium is detected, there are evidence-based strategies that can help to mitigate the effects of that delirium. Those are non-pharmacological strategies around orientation, information provision, and good medical and nursing support. Now, the whole session was themed around whether someone with cognitive problems can engage in rehab. And the message that I wanted to give was everyone in the stroke team needs to be aware of delirium, not just the medics, not just the psychologists, but the physiotherapists and the occupational therapists and the speech therapists. Because in all of those patient interactions, you have the opportunity to think about delirium, to detect delirium, and then to share that with the whole team so that you can actually do something about the delirium.

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