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Dementia delirium

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https://www.readbyqxmd.com/read/28338808/the-relationship-between-cognitive-impairment-mortality-and-discharge-characteristics-in-a-large-cohort-of-older-adults-with-unscheduled-admissions-to-an-acute-hospital-a-retrospective-observational-study
#1
Carole Fogg, Paul Meredith, Jackie Bridges, Gill P Gould, Peter Griffiths
Background: older people with dementia admitted to hospital for acute illness have higher mortality and longer hospital stays compared to those without dementia. Cognitive impairment (CI) is common in older people, and they may also be at increased risk of poor outcomes. Methods: retrospective observational study of unscheduled admissions aged ≥75 years. Admission characteristics, mortality rates and discharge outcomes were compared between three groups: (i) known dementia diagnosis (DD), (ii) CI but no diagnosis of dementia and (iii) no CI...
February 25, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28331324/update-on-the-treatment-of-parkinson-s-disease-psychosis-role-of-pimavanserin
#2
REVIEW
Brianna L Combs, Arthur G Cox
Parkinson's disease (PD) has a prevalence of nearly 1 million people in the USA, with increasing incidence in the elderly population. Generally, the age of presentation is between 55 and 65 years, with the likelihood of diagnosis increasing as patients reach the age of 80 years or above. Some of the common treatments for PD increase dopamine levels in the brain. Dopaminergic therapy helps to improve motor and non-motor symptoms, but it is not without risks. Dopaminergic therapy can cause confusion, delirium, and psychotic-like behavior...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28331300/dementia-and-delirium-the-outcomes-in-elderly-hip-fracture-patients
#3
Christina A Mosk, Marnix Mus, Jos Pam Vroemen, Tjeerd van der Ploeg, Dagmar I Vos, Leon Hgj Elmans, Lijckle van der Laan
BACKGROUND: Delirium in hip fractured patients is a frequent complication. Dementia is an important risk factor for delirium and is common in frail elderly. This study aimed to extend the previous knowledge on risk factors for delirium and the consequences. Special attention was given to patients with dementia and delirium. METHODS: This is a retrospective cohort study performed in the Amphia Hospital, Breda, the Netherlands. A full electronic patient file system (Hyperspace Version IU4: Epic, Inc...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28330544/-behavioural-disturbances-in-dement-patients
#4
Anette Lolk, Kjeld Andersen
Behavioural and psychological symptoms in dementia are common. The symptoms include anxiety, depression, and psychosis, thus mimicking delirium. A thorough somatic examination, including current medication, is therefore very important before initiating any treatment. If behavioural and psychological symptoms of dementia is established, first-line treatment is non-pharmacological addressing possible needs and psychosocial problems. Only if this treatment is insufficient, pharmacological treatment can be considered...
March 20, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28329149/prediction-of-long-term-cognitive-decline-following-postoperative-delirium-in-older-adults
#5
Elizabeth E Devore, Tamara G Fong, Edward R Marcantonio, Eva M Schmitt, Thomas G Travison, Richard N Jones, Sharon K Inouye
Background: Increasing evidence suggests that postoperative delirium may result in long-term cognitive decline among older adults. Risk factors for such cognitive decline are unknown. Methods: We studied 126 older participants without delirium or dementia upon entering the Successful AGing After Elective Surgery (SAGES) study, who developed postoperative delirium and completed repeated cognitive assessments (up to 36 months of follow-up). Pre-surgical factors were assessed preoperatively and divided into nine groupings of related factors ("domains")...
March 15, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28320171/stroke-severity-predicts-poststroke-delirium-and-its-association-with-dementia-longitudinal-observation-from-a-low-income-setting
#6
Akin Ojagbemi, Mayowa Owolabi, Toyin Bello, Olusegun Baiyewu
OBJECTIVE: The effect of delirium on stroke outcome has not been quantified in sub-Saharan Africa. We investigated the prevalence of delirium occurring within one week of stroke in Nigerian survivors and its association with dementia and mortality at 3months. METHODS: Delirium was ascertained after repeated assessments within one week of stroke using the Confusion Assessment Method. Demographic and clinical characteristics, stroke severity, current and pre-morbid cognitive functioning were also assessed...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28294711/potential-bedside-utility-of-the-clock-drawing-test-in-evaluating-rapid-therapeutic-response-in-the-natural-course-of-schizophrenia-a-preliminary-study
#7
Ramdas Sarjerao Ransing, Praveen Homdeorao Khairkar, Kshirod Mishra, Gajanan Sakekar
The Clock-Drawing Test (CDT) is a brief, relatively time-efficient, easy to administer at bedside, and well-proven cognitive screening test that assesses a broad range of cognitive abilities in stroke, delirium, and dementia. However, challenges of comprehensive therapeutic outcome evaluations in schizophrenia can also be potentially overcome using CDT. The authors aimed to measure the therapeutic outcome using CDT in 101 schizophrenia patients, irrespective of their diagnostic subtypes. A repeated measures analysis of variance found that improvements on CDT and the Positive and Negative Syndrome Scale were closely correlated, reflecting critical information about therapeutic response measures in schizophrenia...
March 15, 2017: Journal of Neuropsychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/28291818/challenges-and-opportunities-in-understanding-dementia-and-delirium-in-the-acute-hospital
#8
Thomas A Jackson, John R F Gladman, Rowan H Harwood, Alasdair M J MacLullich, Elizabeth L Sampson, Bart Sheehan, Daniel H J Davis
In an Essay, Andrew Jackson and colleagues discuss challenges in the diagnosis and management of older people with dementia and delirium in acute hospitals.
March 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28291765/cervical-spine-surgery-complications-and-risks-in-the-elderly
#9
Kris Radcliff, Kevin L Ong, Scott Lovald, Edmund Lau, Mark Kurd
STUDY DESIGN: Cervical decompression (CD) and cervical fusion (CF) patients in 5% Medicare Part B claims data. OBJECTIVE: Evaluate the complication rate and associated risk factors after cervical spine surgery using a national sample of elderly patients. SUMMARY OF BACKGROUND DATA: The number of cervical spine procedures in the United States has risen along with associated hospital costs. Postoperative complications lead to longer hospitalizations and greater costs...
March 15, 2017: Spine
https://www.readbyqxmd.com/read/28291299/-neurosyphilis-in-psychiatric-settings-three-case-reports
#10
Erhan Akıncı, Fatih Öncü, Barış Topçular
Syphilis is a generally sexually transmitted and multisystem disease caused by the spirochete Treponema pallidum. All of the organs of the body may be involved during the course of the disease. Neurosyphilis is a clinical form of syphilis with the central nervous system (CNS) involvement. While primarily meningeal and vascular structures are involved in early neurosyphilis, a parenchymal affection of the brain and spinal cord emerges at later stages of neurosyphilis. It presents with symptoms of meningitis, meningovasculitis and parenchymal neurosyphilis (presenting as tabes dorsalis and general paresis)...
2017: Türk Psikiyatri Dergisi, Turkish Journal of Psychiatry
https://www.readbyqxmd.com/read/28288622/cogchamps-a-model-of-implementing-evidence-based-care-in-hospitals-study-protocol
#11
Catherine Travers, Frederick Graham, Amanda Henderson, Elizabeth Beattie
BACKGROUND: Delirium and dementia (cognitive impairment; CI), are common in older hospital patients, and both are associated with serious adverse outcomes. Despite delirium often being preventable, it is frequently not recognized in hospital settings, which may be because hospital nurses have not received adequate education or training in recognizing or caring for those with CI. However, the most effective way of increasing nurses' awareness about delirium and dementia, and initiating regular patient screening and monitoring to guide best practices for these patients in hospital settings is not known...
March 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28283381/a-comprehensive-review-of-the-quality-and-feasibility-of-dementia-assessment-measures-the-dementia-outcomes-measurement-suite
#12
REVIEW
Adam Bentvelzen, Liesbeth Aerts, Katrin Seeher, Jacqueline Wesson, Henry Brodaty
The diagnosis of dementia and the management of its associated symptoms are aided by high-quality assessment tools. However, there is disagreement on the optimal tools among abundant alternatives and lack of consistent quality standards across the different domains of dementia-related change (ie, cognition, severity, function, behavioral and psychological symptoms, delirium, quality of life). Standardization is difficult because the relevance of a measurement tool for health professionals may depend on the clinical setting and on the dementia type and severity...
March 7, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28282301/postoperative-confusion-in-older-adults
#13
Freddi Segal-Gidan
The development of postoperative confusion in older patients is increasingly being recognized as clinically significant because it is becoming more common as the population ages. Postoperative delirium and postoperative cognitive dysfunction differ in time course of development. Risk factors other than age include certain medications as well as anesthesia (both the type and amount used). Postoperative delirium and postoperative cognitive dysfunction appear to increase a patient's risk for developing dementia...
March 9, 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28280733/the-association-of-serum-levels-of-brain-derived-neurotrophic-factor-with-the-occurrence-of-and-recovery-from-delirium-in-older-medical-inpatients
#14
John Williams, Karen Finn, Vincent Melvin, David Meagher, Geraldine McCarthy, Dimitrios Adamis
Limited studies of the association between BDNF levels and delirium have given inconclusive results. This prospective, longitudinal study examined the relationship between BDNF levels and the occurrence of and recovery from delirium. Participants were assessed twice weekly using MoCA, DRS-R98, and APACHE II scales. BDNF levels were estimated using an ELISA method. Delirium was defined with DRS-R98 (score > 16) and recovery from delirium as ≥2 consecutive assessments without delirium prior to discharge...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28278359/qualitative-evaluation-of-a-delirium-prevention-and-management-programme
#15
Yun Kang, Wendy Moyle, Marie Cooke, Siobhan O'Dwyer
AIMS AND OBJECTIVES: To evaluate the effect of an educational programme on registered nurses' knowledge and attitude in delirium care for hospitalised older adults with and without dementia, and to examine the strengths and weaknesses of the programme from the participants' perspectives. BACKGROUND: Providing care for patients with delirium or delirium superimposed on dementia often poses particular challenges such as distinguishing between delirium and dementia for nurses...
March 9, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28275701/sleep-wake-cycle-disturbances-in-elderly-acute-general-medical-inpatients-longitudinal-relationship-to-delirium-and-dementia
#16
James M FitzGerald, Niamh O'Regan, Dimitrios Adamis, Suzanne Timmons, Colum P Dunne, Paula T Trzepacz, David J Meagher
INTRODUCTION: Sleep disturbances in elderly medical inpatients are common, but their relationship to delirium and dementia has not been studied. METHODS: Sleep and delirium status were assessed daily for a week in 145 consecutive newly admitted elderly acute general hospital patients using the Delirium Rating Scale-Revised-98 (DRS-R98), Diagnostic and Statistical Manual 5, and Richards-Campbell Sleep Quality Scale measures. The longitudinal relationship between DRS-R98 and Richards-Campbell Sleep Quality Scale sleep scores and delirium, also with dementia as a covariate, was evaluated using generalized estimating equation logistic regression...
2017: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring
https://www.readbyqxmd.com/read/28271556/where-next-for-delirium-research
#17
Rowan H Harwood, Elizabeth Teale
Clinicians who manage delirium must do so without key information required for evidence-based practice, not least lack of any clearly effective treatment for established delirium. Both the nature of delirium and the methods used to research it contribute to difficulties. Delirium is heterogeneous, with respect to motor subtype, aetiology, setting and the co-existence of dementia, and may be almost inevitable towards the end of life. Elements of assessment are subjective, so diagnosis can be uncertain or unreliable...
March 8, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28263444/delirium-in-the-emergency-department-and-its-extension-into-hospitalization-delineate-study-effect-on-6-month-function-and-cognition
#18
Jin H Han, Eduard E Vasilevskis, Rameela Chandrasekhar, Xulei Liu, John F Schnelle, Robert S Dittus, E Wesley Ely
BACKGROUND: The natural course and clinical significance of delirium in the emergency department (ED) is unclear. OBJECTIVES: We sought to (1) describe the extent to which delirium in the ED persists into hospitalization (ED delirium duration) and (2) determine how ED delirium duration is associated with 6-month functional status and cognition. DESIGN: Prospective cohort study. SETTING: Tertiary care, academic medical center...
March 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28259697/antipsychotic-use-and-physical-morbidity-in-parkinson-disease
#19
Daniel Weintraub, Claire Chiang, Hyungjin Myra Kim, Jayne Wilkinson, Connie Marras, Barbara Stanislawski, Eugenia Mamikonyan, Helen C Kales
OBJECTIVE: To determine if antipsychotic (AP) use in Parkinson disease (PD) patients is associated with increased physical morbidity. METHODS: Veterans Health Administration data (1999-2010) was used to examine physical morbidity risk associated with AP use in idiopathic PD patients with stable recent physical health. We compared 180-day morbidity rates in patients initiating an AP with matched non-AP users who survived for 180 days (matched on age, sex, race, index year, presence and duration of dementia, PD duration, delirium, hospitalization, Charlson Comorbidity Index, and new non-psychiatric medications; covarying for psychosis)...
February 2, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28246074/delirium-after-mechanical-ventilation-in-intensive-care-units-the-cognitive-and-psychosocial-assessment-capa-study-protocol
#20
Daniella Bulic, Michael Bennett, Helen Rodgers, Mary Nourse, Patrick Rubie, Jeffrey Cl Looi, Frank Van Haren
BACKGROUND: In the intensive care unit (ICU), critical illness delirium occurs in the context of multiple comorbidities, multi-organ failure, and invasive management techniques, such as mechanical ventilation, sedation, and lack of sleep. Delirium is characterized by an acute confusional state defined by fluctuating mental status, inattention, and either disorganized thinking or an altered level of consciousness. The long-term cognitive and psychosocial function of patients that experience delirium in the ICU is of crucial interest because preliminary data suggest a strong association between ICU-related delirium and long-term cognitive impairment...
February 28, 2017: JMIR Research Protocols
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