Many clinicians do not realize the costs associated with delirium. Francis and Kapoor found that patients who had had delirium had higher two-year mortality rates and greater loss of independence than control patients. The investigators also reported a trend toward decline in cognitive performance among patients who had had delirium. Levkoff and coworkers found that delirium was associated with no change in mortality, but that it was associated with prolonged hospital stays and an increased risk of institutional placement among community dwelling elderly. Poor outcomes might be avoided, in part, with early diagnosis and appropriate management of delirium.