譫妄症(delirium)是一種急性專注力及認知功能的病態改變，尤其更常發生於65歲以上的老人族群，譫妄症往往會造成龐大的醫療花費，且易被忽略，更可能進一步造成老年病患的死亡。由於譫妄症常是多重因素所共同造成的臨床表現，因此在處理上也常需要多方向並進的治療。目前並無強力的證據顯示有真正有功效的藥物治療，反而較建議減少使用止痛鎮靜藥物及非藥物的介入處理方式。譫妄症是病患安全的重要指標，所以我們將在文中探討老人譫妄症相關最新的診療指引及病理生理機轉。

Delirium is one kind of acute pathological changes for attention and cognitive function, especially for those who are more than 65 years old. Delirium often costs a lot of medical resources, and it is easy to be ignored. Furthermore, it could result in mortality in the elderly. Due to the multifactorial causes, the management of delirium usually need multi-directional treatment. Currently, there is no strong evidence for any medication to treat delirium. On the contrary, we suggest tapering the dosage of analgesics, sedatives, and hypnotics, and recommend non-pharmacological management. The care quality of delirium is an important indicator for patient safety. Therefore, we will discuss about the mechanisms and treatment strategies of delirium in the elderly. (J Intern Med Taiwan 2014; 25: 143-150)