**3.1.6 Depression**

Depression has been reported to be a predisposing factor for delirium in the elderly (Elie et al., 1998) and in non-cardiac surgical patients (Dasgupta and Dumbrell, 2006). The reduced functional connectivity in the human brain which is associated with depression (Anand et al., 2005) was hypothesized to be one of the mechanisms that predispose depressive patients to delirium (Sanders, 2011). On the other hand, the authors of the data synthesis commissioned by the National Institute for Health and Clinical Excellence (NICE) reported

The most common of delirium in hip fracture patients were reported as drugs that have central nervous system effects, infections, fluid-electrolyte disturbances, metabolic/ endocrine disturbances, intracranial processes, cardiopulmonary compromise and/or drug

Medical comorbidities such as burns (Palmu, 2011), cancer (Bond et al., 2011), cardiovascular disease (Branco et al., 2011), and alcoholism (Pompei et al., 1994) are among the predisposing factors for delirium. Sensory impairments like visual impairment and functional dependence also predispose individuals to delirium (Burns et al., 2004). In a study investigating a multifactorial model of delirium etiology, a predictive model was formed and 4 predisposing factors were identified for delirium: vision impairment, severe

Having a severe illness and staying in intensive care unit are also predisposing factors for delirium. Delirium has been reported in up to 80% of critically ill patients (Ouimet et al., 2007). Delirium is an independent predictor of adverse intensive care unit outcomes, including increased risk of death, longer hospital stay, and higher costs (Ely et al., 2004;

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

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

Depression has been reported to be a predisposing factor for delirium in the elderly (Elie et al., 1998) and in non-cardiac surgical patients (Dasgupta and Dumbrell, 2006). The reduced functional connectivity in the human brain which is associated with depression (Anand et al., 2005) was hypothesized to be one of the mechanisms that predispose depressive patients to delirium (Sanders, 2011). On the other hand, the authors of the data synthesis commissioned by the National Institute for Health and Clinical Excellence (NICE) reported

withdrawal and sensory/environmental causes (Brauer et al., 2000).

illness, cognitive impairment and BUN/creatinine ratio of 18 (Inouye, 1999).

**3.1.4 Severe, traumatic or systematic illnesses** 

Milbrandt et al., 2004; Thomason et al., 2005).

have contributed to the increased risk of delirium in men.

**3.1.5 Male gender** 

progressed (Banks, 2001).

**3.1.6 Depression**

uncertainty for depression as a precipitating factor for delirium (National Clinical Guideline Center; Steiner, 2011).
