Problem:
Delirium is characterized by a state of acute confusion and altered consciousness, often resulting from an underlying medical condition or external factors. Its pathophysiology is not fully understood, but it is believed to involve disturbances in various neurotransmitter systems, inflammation, and alterations in cerebral metabolism (McCance et al., 2023). One key contributor to delirium is an imbalance in acetylcholine, a neurotransmitter crucial for cognitive functions. Reduced acetylcholine levels, often attributed to impaired cholinergic activity, have been observed in delirious patients. This imbalance is thought to result from various factors, including medications with anticholinergic effects, underlying medical conditions, or inflammatory responses (Echeverria et al., 2022). Additionally, alterations in dopamine transmission, particularly excess dopamine activity, have been implicated in delirium. Disruption in the delicate balance between acetylcholine and dopamine is believed to contribute to the onset and progression of delirium. Furthermore, inflammation plays a significant role in the pathophysiology of delirium. Systemic inflammatory responses, often triggered by infections or other medical conditions, can lead to the release of inflammatory mediators that affect the brain (Maclullich et al., 2008). This neuroinflammation disrupts normal neuronal function and contributes to the cognitive disturbances seen in delirium. The blood-brain barrier may become more permeable during inflammation, allowing inflammatory substances to enter the brain and exert their effects on neural networks. Cerebral metabolism alterations also contribute to delirium. Factors such as hypoxia, hypoperfusion, or disruptions in glucose metabolism can compromise energy supply to the brain. This energy deficit affects neuronal function, contributing to the cognitive deficits observed in delirium (Maclullich et al., 2008). Furthermore, predisposing and precipitating factors influence an individual's susceptibility to delirium. Predisposing factors, such as advanced age, pre-existing cognitive impairment, and comorbidities, create a vulnerability to delirium. Precipitating factors, including medications, infections, and surgery, can act as triggers that precipitate delirium in susceptible individuals. In summary, delirium involves a complex interplay of neurotransmitter imbalances, inflammation, and alterations in cerebral metabolism.