**3.1.5 Male gender**

Male gender was found to be a risk factor in some of the studies of delirium (Williams-Russo et al., 1992**;** Fisher & Flowerdew, 1995; Kolbeinsson & Jonsson, 1993; Schor et al., 1992; Edlund et al., 2001). In the meta-analysis of Elie et al., a statistically significant relative risk of 1.9 was found for the male gender (1998). In a study that investigated the differences between preoperative and postoperative delirium regarding predisposing, precipitating factors and outcome in older patients admitted to hospital with femoral neck fractures, it was found that the men with femoral neck fractures were in poorer health than the women, except that more female patients had hypertension and were treated with diuretics (Edlund et al., 2001). In the same study, male patients were reported to suffer more postoperative complications and have higher long-term mortality (Edlund et al., 2001). These factors might have contributed to the increased risk of delirium in men.

Another factor contributing to the increased risk of delirium in men might be reluctance of men to consult a doctor. Men with health problems were found to be more likely than women to have had no recent contact with a doctor regardless of income or ethnicity (Courtenay, 2000). This reluctance means that men often do not seek help until a disease has progressed (Banks, 2001).
