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Identification of those at increased risk of developing delirium early in the surgical pathway provides an opportunity for modification of predisposing and precipitating risk factors and effective shared decision\u2010making. No single delirium prediction tool is used widely in surgical settings. Multi\u2010component interventions to prevent delirium involve structured risk factor modification supported by geriatrician input; these are clinically efficacious and cost effective. Barriers to the widespread implementation of such complex interventions exist, resulting in an \u2018implementation gap\u2019. There is a lack of evidence for pharmacological prophylaxis for the prevention of delirium. Current evidence suggests that avoidance of peri\u2010operative benzodiazepines, careful titration of anaesthetic depth guided by processed electroencephalogram monitoring and treatment of pain are the most effective strategies to minimise the risk of delirium. Addressing postoperative delirium requires a collaborative, whole pathway approach, beginning with the early identification of those patients who are at risk. The research agenda should continue to examine the potential for pharmacological prophylaxis to prevent delirium while also addressing how successful models of delirium prevention can be translated from one setting to another, underpinned by implementation science methodology.<\/jats:p>","DOI":"10.1111\/anae.15607","type":"journal-article","created":{"date-parts":[[2022,1,10]],"date-time":"2022-01-10T04:03:37Z","timestamp":1641787417000},"page":"92-101","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":247,"title":["Evidence\u2010based strategies to reduce the incidence of postoperative delirium: a narrative review"],"prefix":"10.1111","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9448-2316","authenticated-orcid":false,"given":"C. 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