• Mark A Oldham, Walter Piddoubny, Ryan Peterson, and Hochang B Lee.
• Department of Psychiatry, Yale School of Medicine, 20 York Street, Fitkin 615, New Haven, CT 06510, USA. Electronic address: mark.oldham@yale.edu.
• Crit Care Clin. 2017 Jul 1; 33 (3): 441-459.

AbstractOlder adults account for half of intensive care unit (ICU) admissions and ICU days, and approximately 2 in 5 older adults in the ICU have preexisting cognitive impairment (PCI). PCI identification is important for risk stratification and may influence ICU utilization and decision-making surrogacy. PCI is overlooked in more than half of patients without screening; however, screening instruments can identify PCI in less than 5 minutes. Management of PCI in the ICU involves addressing associated neuropsychiatric symptoms. Nonpharmacological interventions should be considered the mainstay of treatment; psychotropics may be considered, although available data on their efficacy is limited.Copyright © 2017 Elsevier Inc. All rights reserved.

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