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delirium elderly

Tomas L Griebling
No abstract text is available yet for this article.
May 2017: Journal of Urology
Sandeep Grover, Ajit Avasthi
No abstract text is available yet for this article.
February 2018: Indian Journal of Psychiatry
Joanne Brooke, Claire Manneh
AIMS: To explore the lived experience of caring for a patient during an acute episode of delirium by nurses working in cardiology, elderly care, renal, or respiratory specialities. BACKGROUND: A missed or delayed diagnosis of delirium in an acute hospital setting adversely impacts on patient outcomes. Nurses are the best placed health care professionals to identify a change in patient's cognitive status but struggle to do so. DESIGN: Inductive interpretative phenomenology...
March 12, 2018: International Journal of Nursing Practice
Bin Mei, Gaige Meng, Guanghong Xu, Xinqi Cheng, Shishou Chen, Ye Zhang, Ming Zhang, Xuesheng Liu, Erwei Gu
BACKGROUND: Peripheral nerve block is a preferable method for elderly patients receiving hip arthroplasty. Sedation with dexmedetomidine may reduce postoperative delirium. The aim of this study was to investigate whether intraoperative sedation with dexmedetomidine, as a supplementary to peripheral nerve block for elderly patients receiving total hip arthroplasty, can decrease the prevalence of postoperative delirium. METHODS: A prospective, randomized controlled study was conducted with patients 65 years of age or older who underwent total hip arthroplasty between June 2016 and June 2017...
March 9, 2018: Clinical Journal of Pain
Fiammetta Monacelli, Alessio Signori, Matteo Prefumo, Chiara Giannotti, Alessio Nencioni, Emanuele Romairone, Stefano Scabini, Patrizio Odetti
Background/Aims: Postoperative delirium (POD) is more frequent in elderly patients undergoing major cancer surgery. The interplay between individual clinical vulnerability and a series of perioperative factors seems to play a relevant role. Surgery is the first-line treatment option for cancer, and fast-track surgery (FTS) has been documented to decrease postoperative complications. The study sought to assess, after comprehensive geriatric assessment (CGA) and frailty stratification (Rockwood 40 items index), which perioperative parameters were predictive of POD development in elderly patients undergoing FTS for colorectal cancer...
January 2018: Dementia and Geriatric Cognitive Disorders Extra
Yi-Qing Zou, Xiao-Bao Li, Zhi-Xing Yang, Jing-Min Zhou, Yi-Nan Wu, Zhi-Hu Zhao, Xiang-Zhu Liu, Chang-Li Hu
BACKGROUND: Conflict findings of the impact of inhalational anesthetics on postoperative cognitive function are reported. No systematic review has been performed to solve the problem. The aim of the study was to assess the effect of different inhalational anesthetics on postoperative cognitive function in a network meta-analysis. METHODS: We will search MEDLINE, EMBASE, the Central Register of Controlled Trials in the Cochrane library, and CINAHL for randomized controlled trials or cohort studies assessing the short-term or long-term cognitive function of elderly patients (over 60 years) receiving major surgeries and inhalational anesthetics (desflurane, isoflurane, sevoflurane, halothane, and nitrous oxide) during surgery...
January 2018: Medicine (Baltimore)
Hajime Senjo, Akio Mori, Minoru Kanaya, Koh Izumiyama, Kohei Okada, Kimihiro Takeyabu, Hirotoshi Tobioka, Makoto Saito, Masanori Tanaka, Takanori Teshima, Masanobu Morioka
An 84-year-old man, who had received artificial pneumothorax for pulmonary tuberculosis 67 years previously, complained of severe chest pain. Chest CT revealed chronic pyothorax with multiple heterogeneously enhanced cavity lesions in the wall of the right intrathoracic space.18 FDG-PET revealed that the lesions showed an abnormal uptake. CT-guided biopsy was performed and he was diagnosed with pyothorax-associated lymphoma (PAL); the histological diagnosis was diffuse large B cell lymphoma (DLBCL). Furthermore, immunohistochemical staining revealed that the tumor cells were positive for EBNA-2 and LMP-1, suggesting that the latent gene products of Epstein-Barr virus were associated with the development of PAL...
2018: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Holger Eggebrecht, Kurt Bestehorn, Tienush Rassaf, Maike Bestehorn, Thomas Voigtländer, Eckhard Fleck, Volker Schächinger, Axel Schmermund, Rajendra H Mehta
AIMS: Randomised trials comparing transcatheter aortic valve replacement (TAVR) with surgical aortic valve replacement (SAVR) have included mainly elderly patients >80 years. The authors investigated comparative in-hospital outcomes of younger patients <75 years undergoing transfemoral (TF) TAVR or isolated SAVR. METHODS AND RESULTS: A total of 6,972 patients aged 65-74 years undergoing TF-TAVR or SAVR between 2013 and 2014 were identified from the observational German Quality Assurance Registry on Aortic Valve Replacement (AQUA), which comprises all TAVR and SAVR procedures performed in Germany...
February 27, 2018: EuroIntervention
George Edward Peck, David James Heming Shipway, Kevin Tsang, Michael Fertleman
Developed populations are ageing rapidly and by 2040, approximately 1 in 4 adults will be over 65 years of age. This is resulting in higher incidence of traumatic injury in older patients. Cognitive and physical comorbidities in this group can pose significant challenges. Due to mechanisms of injury and pre-existing degenerative spinal disease, cervical spine fractures are particularly prevalent in elderly patients. These are associated with significant morbidity and mortality. In this literature review we examine current evidence surrounding the use of cervical spine immobilisation in elderly patients in the pre-hospital and emergency department setting and also as a treatment option for cervical spine fractures...
February 28, 2018: British Journal of Neurosurgery
Harriet Riegger, Alexa Hollinger, Burkhardt Seifert, Katharina Toft, Andrea Blum, Tatjana Zehnder, Martin Siegemund
BACKGROUND: Delirium is a neurobehavioural syndrome that frequently develops in the postoperative setting. The incidence of elderly patients who develop delirium during hospital stay ranges from 10 to 80% (Schonauer et al., J Pept Sci. 2017). Delirium was first described more than half a century ago in the cardiac surgery population (Blachy and Starr, Am J Psychiatry 121:371-5, 1964), where it was already discovered as a state that might be accompanied by serious complications such as prolonged ICU and hospital stay, reduced quality of life and increased mortality...
February 26, 2018: Trials
Emmanuelle Magny, Hélène Le Petitcorps, Maria Pociumban, Zineb Bouksani-Kacher, Éric Pautas, Joël Belmin, Sylvie Bastuji-Garin, Carmelo Lafuente-Lafuente
BACKGROUND: Factors associated with delirium among community-dwelling older adults have been poorly studied. Our aim was to describe the prevalence of predisposing and precipitating factors for delirium among patients admitted for delirium and to assess whether these factors were appropriately recognized at the first patient assessment at hospital. METHODS: Consecutive community-dwelling individuals admitted to three geriatric acute care units with a confirmed initial diagnosis of delirium were prospectively included...
2018: PloS One
Sharon K Inouye
This article is based on the M. Powell Lawton Award Lecture that I delivered at the 2016 Gerontological Society of America Annual Meeting. I provide an overview of my journey in geriatric medicine and delirium research. I created new measures, including the Confusion Assessment Method, for identification of delirium; conceptualized a multifactorial risk model; and developed and tested intervention strategies for delirium prevention. The Hospital Elder Life Program arose from this work. In addition, like Dr...
February 23, 2018: Journal of the American Geriatrics Society
Lais Lopes Delfino, Ricardo Shoiti Komatsu, Caroline Komatsu, Anita Liberalesso Neri, Meire Cachioni
This study aims to investigate the association between management and communication strategies and the presence of neuropsychiatric symptoms presented by elderly people with Alzheimer's disease. One hundred and thirty-four family caregivers answered a questionnaire with socio-demographic data and questions regarding the care context, the Small Communication Strategies Scale, the Dementia Management Strategy Scale, and the Neuropsychiatric Inventory. Caregivers used the criticism management strategy more when the elderly presented hallucination, agitation, depression, anxiety, irritability, nighttime behavior, and appetite abnormalities...
January 1, 2018: Dementia
Iris Zahirovic, Gustav Torisson, Carina Wattmo, Elisabet Londos
BACKGROUND: Elderly persons with a dementia diagnosis often suffer from different neuropsychiatric symptoms (NPS) such as delusions, hallucinations, depression, anxiety, irritability and agitation. Currently, the medical treatment for NPS consists mostly of psychotropic medication such as hypnotics/sedatives, anxiolytics and antipsychotics. In elderly persons with dementia, usage of antipsychotics is less appropriate because of the risk of side effects such as parkinsonism, rapid cognitive decline, cerebrovascular events and finally mortality...
February 17, 2018: BMC Geriatrics
Haruhi Yamada, Yukiko Katsumori, Miki Kawano, Shumpei Mori, Ryo Takeshige, Jun Mukai, Hiroshi Imada, Hiroyuki Shimoura, Hachidai Takahashi, Tadasu Horai, Yutaka Okita, Ken-Ichi Hirata
A 73-year-old man, with congestive heart failure due to combined valvar disease, underwent curative surgery. Although the surgery was successful, his clinical course was eventful because of pulmonary complications, and he began to deteriorate mentally. Quetiapine was prescribed, which appeared to effectively settle his mental status. Following the administration of quetiapine, however, he developed acute kidney injury (AKI) that required continuous hemodiafiltration. Subsequent to discontinuation of quetiapine, his renal function gradually improved...
February 9, 2018: Internal Medicine
Gustavo A Constaín, María Victoria Ocampo Saldarriaga, Juan David Velásquez Tirado, María de Los Ángeles Rodríguez-Gázquez, Lina Marcela Betancur Morales, Juan José Rico Escobar, Gustavo Adolfo Castilla Agudelo, Andrés Felipe Maya Osorno
OBJECTIVE: The purpose of the study was to determine the prevalence and characteristics of patients with persistent delirium (PD) at three months after hospital discharge. METHODOLOGY: Longitudinal descriptive study to assess the prevalence and characteristics of in-patients aged 65 years and older in the Clinica Universitaria Bolivariana who met DSM-5 criteria for delirium at admission, at discharge, and at a 3-month follow up assessment. Socio-demographic features were determined, and CGI-S and DRS-R98 scales used...
January 2018: Revista Colombiana de Psiquiatría
Sultan Hassan Alamri, Obay Ahmed Ashanqity, Ahmad Belgeth Alshomrani, Abdelrahman Haytham Elmasri, Muaadh Badr Saeed, Sultan Ahmed Yahya, Abdulhakeem Ibraheem Almasoud, Youssouf Adam, Hani Mohammed Alamoudi, Abdel Moniem Mukhtar
BACKGROUND: Delirium is a common, often undiagnosed disorder in elderly patients, but no studies have been conducted in Saudi Arabia. OBJECTIVES: To determine the prevalence of delirium among elderly patients on admission and to identify associated factors. DESIGN: A cross-sectional study. SETTING: Tertiary care hospital, Saudi Arabia. PATIENTS AND METHODS: Elderly patients were evaluated for delirium within 24 hours of admission using the Confusion Assessment Method (CAM)...
January 2018: Annals of Saudi Medicine
Tammy T Hshieh, Sharon K Inouye, Esther S Oh
Delirium is defined as an acute disturbance in attention and cognition, with significant associated morbidity and mortality. This article discusses the basic epidemiology of delirium and approaches to diagnosing, assessing, and working up patients for delirium. It delineates the pathophysiology and underlying predisposing and precipitating factors for delirium. It also discusses recent advances in prevention and treatment, particularly multicomponent, nonpharmacological interventions.
March 2018: Psychiatric Clinics of North America
E Levinoff, A Try, J Chabot, L Lee, D Zukor, O Beauchet
BACKGROUND: Hip fractures precipitate several acute adverse outcomes in elderly people, thus leading to chronic adverse outcomes. OBJECTIVES: The objective of our study was to examine the clinical characteristics associated with incident delirium in community dwelling elderly individuals who have a hip fracture. DESIGN: Retrospective observational cohort study. SETTING: Data was collected from an academic tertiary hospital affiliated with McGill University...
2018: Journal of Frailty & Aging
R Vella Azzopardi, I Beyer, S Vermeiren, M Petrovic, N Van Den Noortgate, I Bautmans, E Gorus
Ageing is associated both with frailty and cognitive decline. The quest for a unifying approach has led to a new concept: cognitive frailty. This systematic review explores the contribution of cognitive assessment in frailty operationalization. PubMed, Web of Knowledge and PsycINFO were searched until December 2016 using the keywords aged; frail elderly; aged, 80 and over; frailty; diagnosis; risk assessment and classification, yielding 2,863 hits. Seventy-nine articles were included, describing 94 frailty instruments...
February 2, 2018: Ageing Research Reviews
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