People with mild cognitive impairment can ask how medicines affect delirium risk and when stopping a drug may help. The World Health Organization is developing a guideline on prevention, diagnosis and management of delirium in older adults that explicitly includes medication safety and deprescribing, according to the World Health Organization call for experts. Delirium is sudden confusion with reduced attention and awareness. The World Health Organization describes it as common, serious and often preventable in older adults, linked to higher illness, death, functional decline and health-care costs, yet under-recognized.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- What is WHO doing in 2026?
- Which medicines raise concern for delirium?
- What does deprescribing involve?
- What can you ask at your next visit?
- Where does the evidence fall short?
What is WHO doing in 2026?
The World Health Organization is recruiting experts to write the delirium guideline. The work covers prevention, diagnosis and management in older adults, with medication safety and deprescribing named as part of the scope.
The schedule confirms active 2026 work. The World Health Organization set 7 Oct 2026 as the application deadline for the guideline methodologist, with work scheduled Oct-Dec 2026 and possibly into 2027, according to the World Health Organization methodologist notice.
Which medicines raise concern for delirium?
The American Geriatrics Society advises avoiding several drug groups in older adults with or at high risk of delirium. The list includes anticholinergics, benzodiazepines, antipsychotics for behavioral problems, corticosteroids and sedative-hypnotic Z-drugs, according to the 2023 AGS Beers Criteria.
Count matters as well as type. Using more than one anticholinergic drug increases risk of cognitive decline, delirium and falls or fractures, so the American Geriatrics Society advises minimizing anticholinergic count. People with mild cognitive impairment can ask a pharmacist or prescriber to count these drugs across all prescriptions, over-the-counter products and sleep aids.
What does deprescribing involve?
Deprescribing means supervised withdrawal of inappropriate medicines where harms outweigh benefits. A 2021 narrative review defines it as a process done through patient involvement, shared decision-making and goal-directed care, according to the 2021 deprescribing definition review.
For people with dementia, a 2025 roadmap advises clinicians to ask whether each drug will help within remaining lifespan. It also advises prioritizing stopping strongly anticholinergic drugs, benzodiazepines and sedative-hypnotics. That question about time to benefit can be useful for people with mild cognitive impairment who take many long-term medicines.
What can you ask at your next visit?
Bring a complete list of drugs, doses, sleep aids and as-needed medicines. Ask which ones have anticholinergic effects and whether the total number can be reduced.
Ask about safer options for sleep, anxiety, allergy, bladder symptoms and pain. Use these prompts to guide shared decisions:.
- Could any of my medicines raise my risk of delirium or falls?
- Is there one we could lower, stop or replace first, with a clear taper and follow-up plan?
- How will we watch for withdrawal, return of symptoms and thinking changes after a change?
- When should we review the list again?
Where does the evidence fall short?
A key test of hospital deprescribing shows why careful follow-up matters. An intensive-care randomized trial of electronic plus pharmacist deprescribing of anticholinergics and benzodiazepines did not reduce exposure. Because exposure did not fall, the trial could not show whether deprescribing reduces delirium.
That result does not make review useless. It means stopping risky drugs can be difficult during acute illness, especially without a clear taper, owner and monitoring plan. Ask who will lead the taper, what to report and when to seek urgent care.
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