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Dementia delirium

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https://www.readbyqxmd.com/read/28723773/development-and-validation-of-risk-stratification-delirium-prediction-model-for-critically-ill-patients-a-prospective-observational-single-center-study
#1
Yu Chen, Hang Du, Bao-Hua Wei, Xue-Ni Chang, Chen-Ming Dong
The objective is to develop a model based on risk stratification to predict delirium among adult critically ill patients and whether early intervention could be provided for high-risk patients, which could reduce the incidence of delirium.We designed a prospective, observational, single-center study. We examined 11 factors, including age, APACHE-II score, coma, emergency operation, mechanical ventilation (MV), multiple trauma, metabolic acidosis, history of hypertension, delirium and dementia, and application of Dexmedetomidine Hydrochloride...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28720164/the-detection-diagnosis-and-impact-of-cognitive-impairment-among-inpatients-aged-65-years-and-over-in-an-irish-general-hospital-a-prospective-observational-study
#2
Clodagh Power, Richard Duffy, Helena Bates, Mike Healy, Petrina Gleeson, Brian A Lawlor, Elaine Greene
BACKGROUND: The diagnosis of dementia remains inadequate, even within clinical settings. Data on rates and degree of impairment among inpatients are vital for service planning and the provision of appropriate patient care as Ireland's population ages. METHODS: Every patient aged 65 years and over admitted over a two-week period was invited to participate. Those who met inclusion criteria were screened for delirium then underwent cognitive screening. Demographic, functional, and outcome data were obtained from medical records, participants, and family...
July 19, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28715077/age-and-gender-related-peculiarities-of-patients-with-delirium-in-the-cardiac-intensive-care-unit
#3
Pranas Serpytis, Petras Navickas, Alvydas Navickas, Rokas Serpytis, Giedrius Navickas, Sigita Glaveckaite
BACKGROUND: The overall evidence base regarding delirium has been growing steadily over the past few decades. There has been considerable analysis of delirium concerning, for example, mechanically ventilated patients, patients in the general intensive care unit (ICU) setting, and patients with exclusively postoperative delirium. Nevertheless, there are few studies regarding delirium in a cardiovascular ICU (ICCU) setting and especially scarce literature about the particular features of delirium relating to patient age and gender...
July 17, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28700610/perioperative-hemodynamics-and-risk-for-delirium-and-new-onset-dementia-in-hip-fracture-patients-a-prospective-follow-up-study
#4
Bjørn Erik Neerland, Maria Krogseth, Vibeke Juliebø, Anette Hylen Ranhoff, Knut Engedal, Frede Frihagen, Johan Ræder, Torgeir Bruun Wyller, Leiv Otto Watne
BACKGROUND: Delirium is common in hip fracture patients and many risk factors have been identified. Controversy exists regarding the possible impact of intraoperative control of blood pressure upon acute (delirium) and long term (dementia) cognitive decline. We explored possible associations between perioperative hemodynamic changes, use of vasopressor drugs, risk of delirium and risk of new-onset dementia. METHODS: Prospective follow-up study of 696 hip fracture patients, assessed for delirium pre- and postoperatively, using the Confusion Assessment Method...
2017: PloS One
https://www.readbyqxmd.com/read/28677230/delirium-in-a-residential-care-facility-an-exploratory-study-of-staff-knowledge
#5
Amy Buettel, Michelle Cleary, Marguerite Bramble
OBJECTIVE: To explore staff knowledge of delirium by eliciting meaning through descriptions of their experiences within a residential aged care facility (RACF). METHODS: Six staff from one RACF in Australia participated in this qualitative study. Semi-structured individual interviews were conducted and analysed using Colaizzi's analytical framework. RESULTS: The analysis revealed four themes: (i) absence of the word delirium; (ii) care based on intuition and automated actions; (iii) reliance on teamwork; and (iv) confusing delirium, depression and dementia...
July 5, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/28664794/making-the-right-moves
#6
Elaine Cole
Liaison psychiatry team lead Nicola Wood's collaborative approach to improving the care of older patients with dementia is enabling nurses to reduce the risk of delirium and distress.
June 30, 2017: Nursing Older People
https://www.readbyqxmd.com/read/28661543/implementing-nurse-facilitated-person-centered-care-approaches-for-patients-with-delirium-superimposed-on-dementia-in-the-acute-care-setting
#7
Andrea Yevchak, Donna M Fick, Ann M Kolanowski, Jane McDowell, Todd Monroe, Anna LeViere, Lorraine Mion
Little is understood about the use of person-centered care (PCC) for individuals with delirium superimposed on dementia (DSD), especially in the acute care setting. As part of a larger clinical trial, the purpose of the current exploratory study was to describe examples and qualitatively derived themes of nurse-facilitated PCC for hospitalized older adults with dementia and delirium. A total of 750 delirium rounds were analyzed across three diverse acute care sites. Qualitative derived themes of PCC included: (a) Knowing the Patient's Baseline; (b) Knowing the Patient's Interests and Values; (c) Enhancing Sensory Abilities to Communicate; (d) Individualizing Cognitive Stimulation; and (e) Enhancing Behavioral Approaches to Comfort and Sleep...
June 26, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/28660596/risk-factors-for-mortality-in-elderly-patients-with-hip-fractures-a-meta-analysis-of-18-studies
#8
Yan Liu, Zhiqian Wang, Wenliang Xiao
BACKGROUND: Hip fracture is common and associated with poor outcomes in elderly patients. This meta-analysis aims to investigate the risk factors that might increase the mortality rate in elderly patients with hip fracture. METHODS: PubMed, Embase, and Web of Science were systematically searched for observational studies regarding the prognostic factors of mortality in elderly patients with hip fracture. A fixed-effects or random-effects model was used to calculate pooled hazard ratio (HR) and 95% confidence intervals (95% CIs)...
June 28, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28653147/-altered-orientation-and-aggressiveness-in-an-89-year-old-woman
#9
M Kowar, A H Jacobs
An 89-year-old woman with Alzheimer's dementia was admitted because of altered orientation, aggressiveness and inability to take care of herself at home. Her patient history indicated that 14 days ago the battery of the pacemaker had be renewed. During that time the patient suffered from psychomotor alterations. Therefore, melperone had been initiated. Inspection of the urine and laboratory findings pointed towards an acute exacerbation of acute intermittent porphyria as a possible cause of the delirium. After discontinuation of melperone with additional parenteral therapy with physiological fluids, the signs of delirium significantly improved...
June 26, 2017: Der Internist
https://www.readbyqxmd.com/read/28642002/development-of-geriatric-mental-health-learning-objectives-for-medical-students-a-response-to-the-institute-of-medicine-2012-report
#10
Susan W Lehmann, William B Brooks, Dennis Popeo, Kirsten M Wilkins, Mary C Blazek
America is aging as the population of older adults increases. The shortage of geriatric mental health specialists means that most geriatric mental healthcare will be provided by physicians who do not have specialty training in geriatrics. The Institute of Medicine Report of 2012 highlighted the urgent need for development of national competencies and curricula in geriatric mental health for all clinicians. Virtually all physicians can expect to treat older patients with mental health symptoms, yet currently there are no widely accepted learning objectives in geriatric mental health specific for medical students...
May 12, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28639232/-electroencephalography-in-delirium-superimposed-on-dementia
#11
Judith I Hanemaaijer, Viona J M Wijnen, W A van Gool
Recognizing delirium superimposed on pre-existing cognitive impairment or dementia, 'delirium superimposed on dementia' (DSD), is challenging because signs of delirium might be interpreted as symptoms of pre-existing cognitive dysfunction.In this paper, we review the literature on the role of electrencephalography (EEG) in the differential diagnosis of delirium, dementia and DSD.Conventional EEG, applying twenty to thirty electrodes, taking thirty minutes registration, is not feasible in psychogeriatric patients...
June 21, 2017: Tijdschrift Voor Gerontologie en Geriatrie
https://www.readbyqxmd.com/read/28631875/nursing-assessment-as-an-effective-tool-for-the-identification-of-delirium-risk-in-older-in-patients-a-case-control-study
#12
Elena Solà-Miravete, Carlos López, Estrella Martínez-Segura, Mireia Adell-Lleixà, Maria Eulàlia Juvé-Udina, Mar Lleixà-Fortuño
AIMS: To evaluate the usefulness of comprehensive nursing assessment as a strategy for determining the risk of delirium in older in-patients from a model of care needs based on variables easily measured by nurses. BACKGROUND: There are many scales of assessment and prediction of risk of delirium, but they are little known and infrequently used by professionals. Recognition of delirium by doctors and nurses continues to be limited. DESIGN AND METHODS: A case-control study...
June 20, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28628893/one-year-mortality-after-hip-fracture-in-older-individuals-the-effects-of-delirium-and-dementia
#13
Rebecca Mitchell, Lara Harvey, Henry Brodaty, Brian Draper, Jacqueline Close
BACKGROUND: Delirium is common in older hip fracture patients, yet its association with mortality after hip fracture remains uncertain. This study aimed to determine whether delirium was associated with all-cause one-year mortality after hip fracture in older patients and whether the effect of delirium was independent of dementia status. METHOD: A retrospective analysis of linked hospitalisation and mortality data for patients aged ≥65 years with a hip fracture during 1 January 2010 to 30 June 2014 in New South Wales, Australia...
September 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28625940/prodromal-stage-of-disease-dementia-with-lewy-bodies-how-to-diagnose-in-practice
#14
Frédéric Blanc, Marc Verny
Disease with Lewy bodies or dementia with Lewy bodies (DLB), particularly at the prodromal stage, is a complex disease to diagnose because of different clinical beginnings and variable paths in terms of clinical expression. Thus DLB can be entcountered in different input modes: mild cognitive impairment, depression, acute behavioral disorders, confusion and delirium, or sleep disorders. In the aim to better diagnose the disease, should be sought obviously to search for the key symptoms: fluctuations, hallucinations, extra-pyramidal syndrome, and REM sleep behavior disorder...
June 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28579352/clinical-features-associated-with-delirium-motor-subtypes-in-older-inpatients-results-of-a-multicenter-study
#15
Alessandro Morandi, Simona G Di Santo, Antonio Cherubini, Enrico Mossello, David Meagher, Andrea Mazzone, Angelo Bianchetti, Nicola Ferrara, Alberto Ferrari, Massimo Musicco, Marco Trabucchi, Giuseppe Bellelli
OBJECTIVE: To date motor subtypes of delirium have been evaluated in single-center studies with a limited examination of the relationship between predisposing factors and motor profile of delirium. We sought to report the prevalence and clinical profile of subtypes of delirium in a multicenter study. METHODS: This is a point prevalence study nested in the "Delirium Day 2015", which included 108 acute and 12 rehabilitation wards in Italy. Delirium was detected using the 4-AT and motor subtypes were measured with the Delirium Motor Subtype Scale (DMSS)...
May 4, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28571901/how-can-we-identify-patients-with-delirium-in-the-emergency-department-a-review-of-available-screening-and-diagnostic-tools
#16
Hidetaka Tamune, Daisuke Yasugi
Delirium is a widespread and serious but under-recognized problem. Increasing evidence argues that emergency health care providers need to assess the mental status of the patient as the "sixth vital sign". A simple, sensitive, time-efficient, and cost-effective tool is needed to identify delirium in patients in the emergency department (ED); however, a stand-alone measurement has not yet been established despite previous studies partly because the differential diagnosis of dementia and delirium superimposed on dementia (DSD) is too difficult to achieve using a single indicator...
May 22, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28571816/the-role-of-predictive-coding-in-the-pathogenesis-of-delirium
#17
J M FitzGerald
Delirium and dementia represent an emerging global crisis in healthcare. Attempts have been made to identify the pathognomonic feature that would make delirium stand out from dementia but unfortunately the global neural dysfunction of both disorders has made the establishment of a direct measurement difficult. Modern conceptualisations of delirium have been influenced by the assessment tools used to assess, detect, and analyse its complex and transient nature. Recent publication of the DSM-V criteria for delirium has marginally altered the previous DSM-IV criteria with a focus upon inattention with vague terms such as consciousness downplayed...
June 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28560945/detecting-delirium-superimposed-on-dementia-diagnostic-accuracy-of-a-simple-combined-arousal-and-attention-testing-procedure
#18
Sarah J Richardson, Daniel H J Davis, Giuseppe Bellelli, Wolfgang Hasemann, David Meagher, Stefan H Kreisel, Alasdair M J MacLullich, Joaquim Cerejeira, Alessandro Morandi
BACKGROUND: Detecting delirium superimposed on dementia (DSD) can be challenging because assessment partly relies on cognitive tests that may be abnormal in both conditions. We hypothesized that a combined arousal and attention testing procedure would accurately detect DSD. METHODS: Patients aged ≥70 years were recruited from five hospitals across Europe. Delirium was diagnosed by physicians using DSM-5 criteria using information from nurses, carers, and medical records...
May 31, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28559128/performance-of-the-modified-richmond-agitation-sedation-scale-in-identifying-delirium-in-older-emergency-department-patients
#19
Florian F Grossmann, Wolfgang Hasemann, Reto W Kressig, Roland Bingisser, Christian H Nickel
BACKGROUND: Delirium in older emergency department (ED) patients is associated with severe negative patient outcomes and its detection is challenging for ED clinicians. ED clinicians need easy tools for delirium detection. We aimed to test the performance criteria of the modified Richmond Agitation Sedation Scale (mRASS) in identifying delirium in older ED patients. METHODS: The mRASS was applied to a sample of consecutive ED patients aged 65 or older by specially trained nurses during an 11-day period in November 2015...
May 22, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28554413/the-nonmotor-features-of-parkinson-s-disease
#20
Nataliya Titova, Mubasher A Qamar, K Ray Chaudhuri
Nonmotor symptoms (NMS) of Parkinson's disease (PD) were recognized by the great James Parkinson himself who mentioned symptoms such as sleep dysfunction, delirium, dementia, and dysautonomia, in his seminal 1817 essay, "An Essay on the Shaking Palsy" (Parkinson, 1817). In spite of the key impact of PD NMS on quality of life, there was little holistic research and awareness till the validation and use of comprehensive tools such as the NMS questionnaire, scale, and the revised version of the unified PD rating scale...
2017: International Review of Neurobiology
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