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Dementia delirium

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https://www.readbyqxmd.com/read/29133855/effect-of-short-term-exposure-to-ambient-air-particulate-matter-on-incidence-of-delirium-in-a-surgical-population
#1
Lu Che, Yan Li, Cheng Gan
Delirium remains an independent risk factor for morbidity and mortality among older surgical adults. Recent research has shed light on the relationship between pollution and dementia, yet little is known about the health impacts of particulate matter (PM) on delirium. Therefore, we aim to further explore association of PM and delirium among surgical population. We conducted a time-stratified case-crossover study. Electronic hospitalization summary reports derived from 26 major cities in China between 1 January 2014 and 31 December 2015 were used...
November 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29124114/impact-of-programs-to-reduce-antipsychotic-and-anticholinergic-use-in-nursing-homes
#2
Ryan M Carnahan, Grant D Brown, Elena M Letuchy, Linda M Rubenstein, Brian M Gryzlak, Marianne Smith, Jeffrey C Reist, Michael W Kelly, Susan K Schultz, Michelle T Weckmann, Elizabeth A Chrischilles
Introduction: Antipsychotics are used for managing behavioral and psychological symptoms of dementia (BPSD) but have risks. Anticholinergics can worsen outcomes in dementia. The Improving Antipsychotic Appropriateness in Dementia Patients educational program (IA-ADAPT) and Centers for Medicare and Medicaid Services Partnership to Improve Dementia Care (CMS Partnership) promote improved care for BPSD. The purpose of this study was to evaluate the impact of these programs on medication use and BPSD among nursing home residents...
November 2017: Alzheimer's & Dementia: Translational Research & Clinical Interventions
https://www.readbyqxmd.com/read/29118783/cerebrospinal-fluid-phosphate-in-delirium-after-hip-fracture
#3
Ane-Victoria Idland, Torgeir Bruun Wyller, Randi Støen, Gry Torsæter Dahl, Frede Frihagen, Anne Brækhus, Bjørnar Hassel, Leiv Otto Watne
Aims: Phosphate is essential for neuronal activity. We aimed to investigate whether delirium is associated with altered phosphate concentrations in cerebrospinal fluid (CSF) and serum. Methods: Seventy-seven patients with hip fracture were assessed for delirium before and after acute surgery. Prefracture dementia was diagnosed by an expert panel. Phosphate was measured in CSF obtained immediately before spinal anesthesia (n = 77) and in serum (n = 47). CSF from 23 cognitively healthy elderly patients undergoing spinal anesthesia was also analyzed...
September 2017: Dementia and Geriatric Cognitive Disorders Extra
https://www.readbyqxmd.com/read/29110137/-dementia-friendly-care-services-in-general-hospitals-representative-results-of-the-general-hospital-study-ghost
#4
Ingrid Hendlmeier, Horst Bickel, Johannes Baltasar Hessler, Joshua Weber, Magdalena Nora Junge, Sarah Leonhardt, Martina Schäufele
BACKGROUND: Mostly model projects report on special care services and procedures for general hospital patients with cognitive impairment. The objective of this study was to determine the frequency of special care services and procedures in general hospitals on the basis of a representative cross-sectional study. METHODS: From a list of all general hospitals in southern Germany we randomly selected a specified number of hospitals und somatic wards. The hospitals were visited and all older patients on the selected wards on that day were included in the study...
November 6, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/29100197/using-simulated-family-presence-to-decrease-agitation-in-older-hospitalized-delirious-patients-a-randomized-controlled-trial
#5
Christine M Waszynski, Kerry A Milner, Ilene Staff, Sheila L Molony
BACKGROUND: Simulated family presence has been shown to be an effective nonpharmacological intervention to reduce agitation in persons with dementia in nursing homes. Hyperactive or mixed delirium is a common and serious complication experienced by hospitalized patients, a key feature of which is agitation. Effective nonpharmacological interventions to manage delirium are needed. OBJECTIVES: To examine the effect of simulated family presence through pre-recorded video messages on the agitation level of hospitalized, delirious, acutely agitated patients...
October 7, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29095482/antipsychotics-and-the-risk-of-aspiration-pneumonia-in-individuals-hospitalized-for-nonpsychiatric-conditions-a-cohort-study
#6
Shoshana J Herzig, Mary T LaSalvia, Elliot Naidus, Michael B Rothberg, Wenxiao Zhou, Jerry H Gurwitz, Edward R Marcantonio
BACKGROUND/OBJECTIVES: Off-label use of antipsychotics is common in hospitals, most often for delirium management. Antipsychotics have been associated with aspiration pneumonia in community and nursing home settings, but the association in hospitalized individuals is unexplored. We aimed to investigate the association between antipsychotic exposure and aspiration pneumonia during hospitalization. DESIGN: Retrospective cohort study. SETTING: Large academic medical center...
November 2, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29061154/a-multi-centre-randomised-trial-to-compare-the-effectiveness-of-geriatrician-led-admission-avoidance-hospital-at-home-versus-inpatient-admission
#7
Sasha Shepperd, Andrea Cradduck-Bamford, Chris Butler, Graham Ellis, Mary Godfrey, Alastair Gray, Anthony Hemsley, Pradeep Khanna, Peter Langhorne, Patricia McCaffrey, Lubena Mirza, Maj Pushpangadan, Scott Ramsay, Rebekah Schiff, David Stott, John Young, Ly-Mee Yu
BACKGROUND: There is concern that existing models of acute hospital care will become unworkable as the health service admits an increasing number of frail older people with complex health needs, and that there is inadequate evidence to guide the planning of acute hospital level services. We aim to evaluate whether geriatrician-led admission avoidance to hospital at home is an effective alternative to hospital admission. METHODS/DESIGN: We are conducting a multi-site randomised open trial of geriatrician-led admission avoidance hospital at home, compared with admission to hospital...
October 23, 2017: Trials
https://www.readbyqxmd.com/read/29061098/the-cognitive-reserve-model-in-the-development-of-delirium-the-successful-aging-after-elective-surgery-study
#8
Sevdenur Cizginer, Edward Marcantonio, Sarinnapha Vasunilashorn, Alvaro Pascual-Leone, Mouhsin Shafi, Eva M Schmitt, Sharon K Inouye, Richard N Jones
We evaluated the role of cognitive and brain reserve markers in modifying the risk of postoperative delirium associated with a pathophysiologic marker. The Successful Aging after Elective Surgery study (SAGES) enrolled 556 adults age ≥70 years without dementia scheduled for major surgery. Patients were assessed preoperatively and daily during hospitalization for delirium. We used C-reactive protein (CRP) as a pathophysiologic marker of inflammation, previously associated with delirium. Markers of reserve included vocabulary knowledge, education, cognitive activities, occupation type and complexity, head circumference, intracranial volume, and leisure activities...
November 2017: Journal of Geriatric Psychiatry and Neurology
https://www.readbyqxmd.com/read/29037336/neuropsychiatry-towards-a-philosophy-of-praxis
#9
Jesús Ramirez-Bermudez, Rodrigo Perez-Esparza, Luis Carlos Aguilar-Venegas, Perminder Sachdev
Neuropsychiatry is a specialized clinical, academic and scientific discipline with its field located in the borderland territory between neurology and psychiatry. In this article, we approach the theoretical definition of neuropsychiatry, and in order to address the practical aspects of the discipline, we describe the profile of a neuropsychiatric liaison service in the setting of a large hospital for neurological diseases in a middle-income country. An audit of consecutive in-patients requiring neuropsychiatric assessment at the National Institute of Neurology and Neurosurgery of Mexico is reported, comprising a total of 1212 patients...
October 2017: Revista Colombiana de Psiquiatría
https://www.readbyqxmd.com/read/29036302/a-prospective-observational-study-to-investigate-utility-of-the-delirium-observational-screening-scale-doss-to-detect-delirium-in-care-home-residents
#10
E A Teale, T Munyombwe, M Schuurmans, N Siddiqi, J Young
Background: care home residents are particularly at risk of delirium due to high prevalence of dementia. The Delirium Observation Screening Scale (DOSS) identifies behavioural changes associated delirium onset that nursing staff are uniquely placed to recognise. We tested the psychometric properties of the DOSS in UK care homes compared with the Confusion Assessment Method (CAM). Design: prospective observational cohort study performed between 1 March 2015 and 30 June 2016...
October 5, 2017: Age and Ageing
https://www.readbyqxmd.com/read/29032807/a-comparison-of-the-severe-cognitive-impairment-rating-scale-with-the-mini-mental-state-examination-and-delirium-rating-scale-revised-98-for-delirium-a-cross-sectional-study
#11
So-Hyun Ahn, Jin-Hoon Choi, Chae-Sung Im, Tae-Sung Kim, Jeong Lan Kim
BACKGROUND: Cognitive impairment including attention deficits, disorientation, memory impairment, language disturbance, and impaired visuospatial ability are core symptoms of delirium. The Severe Cognitive Impairment Rating Scale (SCIRS) was developed to assess cognition in patients with severe dementia, but may also be useful in elderly people with delirium. OBJECTIVE: We investigated the use of the SCIRS to assess cognition in elderly patients with delirium. METHODS: We recruited 147 participants, aged ≥65 years, referred for psychiatric consultation at a tertiary-care university hospital...
August 5, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28990640/very-late-onset-schizophrenia-like-psychosis-a-clinical-update
#12
Elizabeth Cort, Jennifer Meehan, Suzanne Reeves, Robert Howard
Psychosis symptoms (delusions and hallucinations) are multifactorial in origin and, in later life, occur in the context of schizophrenia, delirium, dementia, delusional and schizophrenia-like disorders, mood disorders, and alcohol or substance abuse. The current article provides a clinical overview of very late-onset (after age 60) schizophrenia-like psychosis (VLOSLP), summarizing the literature on treatment options and reflecting on the role of psychiatric-mental health nurses (PMHNs). Increased awareness of the clinical presentation, key features, and evidence-based treatment options will assist PMHNs to confidently recognize this often under-diagnosed disorder and adopt a more assertive role in terms of engagement and follow up...
October 6, 2017: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/28985260/validation-of-the-6-item-cognitive-impairment-test-and-the-4at-test-for-combined-delirium-and-dementia-screening-in-older-emergency-department-attendees
#13
Dawn O'Sullivan, Noeleen Brady, Edmund Manning, Emma O'Shea, Síle O'Grady, Niamh O 'Regan, Suzanne Timmons
Background: screening for cognitive impairment in Emergency Department (ED) requires short, reliable tools. Objective: to validate the 4AT and 6-Item Cognitive Impairment Test (6-CIT) for ED dementia and delirium screening. Design: diagnostic accuracy study. Setting/subjects: attendees aged ≥70 years in a tertiary care hospital's ED. Methods: trained researchers assessed participants using the Standardised Mini Mental State Examination, Delirium Rating Scale-Revised 98 and Informant Questionnaire on Cognitive Decline in the Elderly, informing ultimate expert diagnosis using Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria for dementia and delirium (reference standards)...
September 1, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28978301/dying-comfortably-in-very-old-age-with-or-without-dementia-in-different-care-settings-a-representative-older-old-population-study
#14
Jane Fleming, Rowan Calloway, Anouk Perrels, Morag Farquhar, Stephen Barclay, Carol Brayne
BACKGROUND: Comfort is frequently ranked important for a good death. Although rising numbers of people are dying in very old age, many with dementia, little is known about symptom control for "older old" people or whether care in different settings enables them to die comfortably. This study aims to examine, in a population-representative sample, associations between factors potentially related to reported comfort during very old people's final illness: physical and cognitive disability, place of care and transitions in their final illness, and place of death...
October 5, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28974585/routine-screening-in-the-general-hospital-what-happens-after-discharge-to-those-identified-as-at-risk-of-dementia
#15
Ana Phelps, Bethany Kingston, Rose M Wharton, Sarah T Pendlebury
Cognitive screening is recommended for older patients with unplanned hospital admission. We determined rates of reassessment/specialist memory referral after routine inclusion of at risk of dementia status in discharge documentation to primary care. Questionnaires were sent to relevant GP practices on consecutive patients aged ≥75 years identified as at risk and discharged 6 months earlier. Among 53 patients (mean age ±SD = 87.3±6.0 years, mean±SD Abbreviated Mental Test Score = 4.4±2.7), 49 (92%) patients had been reviewed since discharge, and 12/43 (28%) without previously known cognitive problem had had a cognitive reassessment...
October 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28965506/psychiatric-disorders-as-main-discharge-diagnosis-by-the-portuguese-oldest-old-from-2000-to-2014-exploring-national-acute-inpatient-admissions
#16
Daniela Brandão, Alberto Freitas, Constança Paúl, Oscar Ribeiro
BACKGROUND: Mental health problems have been reported as one of the principal causes of incapacity and morbidity. According to the World Health Organization approximately 15% of adults aged 60+ and over suffer from a mental disorder. In the oldest old population, a higher deterioration in the mental state is expected, which is ought to increase the risk of incidence of mental problems and use of healthcare services. The aim of this study is to examine inpatient episodes with a mental disorder coded as primary discharge diagnosis between 2000 and 2014 by patients aged 80+ in Portugal mainland...
October 2, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28954753/dementia-with-lewy-bodies-presenting-as-probable-epileptic-seizure
#17
Mya Z Tun, Wee Kheng Soo, Kevin Wu, Richard Kane
We discuss the case of an 83-year-old man admitted to the hospital after losing control of his vehicle due to an unexplained episode of altered consciousness. This occurred on a background of multiple similar episodes associated with acute confusion, superimposed on a gradual cognitive decline spanning 6 years. Organic aetiologies for delirium were excluded and CT and MRI of the brain were negative for cerebrovascular accidents or other epileptogenic foci. Electroencephalogram (EEG) was negative for epileptiform activity...
September 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28953543/delirium-dementia-and-depression
#18
Katherine Marshall, Deborah Hale
No abstract text is available yet for this article.
October 2017: Home Healthcare Now
https://www.readbyqxmd.com/read/28923236/emergency-nurses-knowledge-and-self-rated-practice-skills-when-caring-for-older-patients-in-the-emergency-department
#19
Helen Rawson, Paul N Bennett, Cherene Ockerby, Alison M Hutchinson, Julie Considine
BACKGROUND: Older adults are high users of emergency department services and their care requirements can present challenges for emergency nurses. Although clinical outcomes for older patients improve when they are cared for by nurses with specialist training, emergency nurses' knowledge and self-assessment of care for older patients is poorly understood. AIM: To assess emergency nurses' knowledge and self-rating of practice when caring for older patients. METHODS: A cross-sectional self-report survey of emergency nurses (n=101) in Melbourne, Australia...
September 8, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28918164/telepsychiatry-consultation-for-medical-and-surgical-inpatient-units
#20
Julie A Graziane, Priya Gopalan, Jack Cahalane
BACKGROUND: Telepsychiatry is becoming more commonplace in the provision of psychiatric care. Most commonly used in the outpatient setting, there is little information available in the literature as to the use of telepsychiatry for inpatient medical/surgical consultation. OBJECTIVE: We review the University of Pittsburgh Medical Center's telepsychiatry consultation program that provides consultation to an outlying community-based rural hospital. METHODS: This article examines the 69 telepsychiatry consultations that were performed from November 2014 through February 2016, looking at the patients served, common consultation questions, and patterns of diagnoses and recommendations...
August 12, 2017: Psychosomatics
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