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Dementia delirium

Ann Kolanowski
No abstract text is available yet for this article.
October 21, 2016: Aging & Mental Health
Jayita De, Anne P F Wand, Peter I Smerdely, Glenn E Hunt
OBJECTIVE: To measure the diagnostic accuracy of the 4A's test in screening for delirium in geriatric inpatients from culturally diverse backgrounds. METHODS: A prospective study was conducted with patients admitted to the geriatric and orthogeriatric services of a tertiary teaching hospital. Consenting participants aged 65 years and over were screened for delirium with the 4AT by nursing staff within 72 h of admission. The diagnosis of delirium was made separately by expert assessors, responsible for the participant's clinical care, blinded to the 4AT score, within 30 min of the 4AT assessment using the DSM 5 criteria and the Confusion Assessment Method...
October 20, 2016: International Journal of Geriatric Psychiatry
Xin Jiang, Dong Chen, Yahao Lou, Zhongshi Li
BACKGROUND: Postoperative delirium is a common complication following various operative procedures with an incidence rate of 10-77 %. AIM: To analyze various risk factors for postoperative delirium after spine surgery in the middle- and old-aged patients. METHODS: This study retrospectively reviewed 451 patients (226 males and 225 females, an average age of 65.1 ± 18.3 years) who underwent spinal surgery in our hospital between January 2010 and August 2015...
October 20, 2016: Aging Clinical and Experimental Research
Javier Suárez Dono, Evelín Cervantes Pérez, Marta Pena Seijo, Francisco Formigo Couceiro, Fernando Ferrón Vidán, Ignacio Novo Veleiro, Esther Del Corral Beamonte, Jesús Díez Manglano, Francisco Gude Sampedro, Antonio Pose Reino
OBJECTIVE: We have followed patients admitted to a Polypathology and Advanced Age Unit for two years in order to identify the variables that best define the mortality prognosis at medium-term (1-2years) for chronic and polypathological patients requiring admission at an Internal Medicine Department. METHODS: This is an observational, prospective study in clinical practice. Polypathological, chronic or multimorbidity patients were included. The classification of the Spanish Ministry for Health was used in order to classify patients as chronic or polypathological...
October 10, 2016: European Journal of Internal Medicine
Jennifer Kirsty Harrison, Azucena Garcia Garrido, Sarah J Rhynas, Gemma Logan, Alasdair M J MacLullich, Juliet MacArthur, Susan Shenkin
BACKGROUND: institutionalisation following acute hospital admission is common and yet poorly described, with policy documents advising against this transition. OBJECTIVE: to characterise the individuals admitted to a care home on discharge from an acute hospital admission and to describe their assessment. DESIGN AND SETTING: a retrospective cohort study of people admitted to a single large Scottish teaching hospital. SUBJECTS: 100 individuals admitted to the acute hospital from home and discharged to a care home...
October 15, 2016: Age and Ageing
Hannah A D Keage, Ashleigh Smith, Tobias Loetscher, Peter Psaltis
Older individuals can now undergo invasive cardiovascular procedures without serious concern about mortality, and the numbers and proportions of the over 65s and 85s doing so in Australia has been increasing over the last 20 years. There is overwhelming evidence linking cardiovascular conditions to late-life (65 years and over) cognitive impairment and dementia including Alzheimer's Disease, primarily due to impaired cerebrovascularisation and cascading neuropathological processes. Somewhat paradoxically, these cardiovascular interventions, carried out with the primary aim of revascularisation, are not usually associated with short- or long-term improvements in cognitive function in older adults...
September 23, 2016: Heart, Lung & Circulation
Yun Kang, Wendy Moyle, Marie Cooke, Siobhan T O'Dwyer
BACKGROUND: The population is ageing in South Korea, increasing the incidence of dementia and delirium. Despite this, registered nurses in South Korea tend to have poor understanding and limited involvement in the assessment of delirium. AIM: To evaluate the effect of an educational programme on acute care nurses' knowledge, attitudes and the potential for family caregiver involvement in care for older adults with cognitive impairment. METHODS: A mixed-methods study that included a single group, pre-post design and individual interviews was used...
October 11, 2016: Scandinavian Journal of Caring Sciences
C Ruggiero, L Bonamassa, L Pelini, I Prioletta, L Cianferotti, A Metozzi, E Benvenuti, G Brandi, A Guazzini, G C Santoro, P Mecocci, D Black, M L Brandi
: This study investigates the relationship between cognitive dysfunction or delirium detected in the early post-surgical phase and the 1-year mortality among 514 hip fracture hospitalized older persons. Patients with early cognitive dysfunction or delirium experienced a 2-fold increased mortality risk. Early post-operative cognitive dysfunction and delirium are negative prognostic factors for mortality. BACKGROUND AND PURPOSE: Premorbid cognitive impairment and dementia in older individuals negatively affect functional recovery after hip fracture...
October 7, 2016: Osteoporosis International
Shelly L Gray, Joseph T Hanlon
Use of medications with anticholinergic activity is widespread in older adults. Several studies have highlighted that anticholinergic use may be associated with an increased risk of dementia. The objective of this narrative review is to describe and evaluate studies of anticholinergic medication use and dementia and provide practical suggestions for avoiding use of these medications in older adults. A comprehensive review of the literature, citations from recent reviews and the author's personal files was conducted...
October 2016: Therapeutic Advances in Drug Safety
Tracy Wharton, Daniel Paulson, Lisa Macri, Leslie Dubin
OBJECTIVES: Aggressive behaviors by patients with dementia present risk to health care workers and patients. An information processing model, developed to study aggressive behaviors among children, was applied to study aggression among older hospital patients with dementia. Hypotheses were that delirium and mental health or depression history, would relate to increased risk of aggressive behaviors. METHOD: Electronic medical records were sampled for one year (n = 5008) and screened using the EMERSE search engine and hand review for dementia (n = 505) and aggressive behavior in individuals with dementia (n = 121)...
September 27, 2016: Aging & Mental Health
Camilla L Wong, Raghda AlAtia, Amanda McFarlan, Holly Y Lee, Christina Valiaveettil, Barbara Haas
BACKGROUND: Proactive geriatric trauma consultation service (GTCS) models have been associated with better delivery of geriatric care and functional outcomes. Whether such collaborative models can be improved and sustained remains uncertain. We describe the sustainability and process improvements of an inpatient GTCS. METHODS: We assessed workflow using interviews and surveys to identify opportunities to optimize the referral process for the GTCS. Sustainability of the service was assessed via a prospective case series (July 2012-December 2013)...
October 1, 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Fernanda Herrera da Costa, Paulo Adilson Herrera, Cecília Luiz Pereira-Stabile, Glaykon Alex Vitti Stabile
Delirium is an organic mental syndrome with acute onset characterized by diffuse brain dysfunction and neural activity disorganization. It is usually related to cognition and perception changes, decreased level of consciousness, and disorganization of thoughts that are unrelated to previous dementia. Occurrence is more frequent in patients with previous degenerative disease and elderly patients, especially those older than 85 years. Although the pathophysiology is not totally known, studies have shown that, among the main factors that lead to delirium, the drugs used for general anesthesia induction are the most relevant (hypnotics, anticholinergic drugs, and H2 receptor blockers), especially those used in long surgical procedures...
August 27, 2016: Journal of Oral and Maxillofacial Surgery
Ane-Victoria Idland, Torgeir Bruun Wyller, Randi Støen, Lars Magne Eri, Frede Frihagen, Johan Ræder, Farrukh Abbas Chaudhry, Oskar Hansson, Henrik Zetterberg, Kaj Blennow, Nenad Bogdanovic, Anne Brækhus, Leiv Otto Watne
BACKGROUND: The clinical relevance of brain β-amyloidosis in older adults without dementia is not established. As delirium and dementia are strongly related, studies on patients with delirium may give pathophysiological clues. OBJECTIVE: To determine whether the Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers amyloid-β 1-42 (Aβ42), total tau (T-tau), and phosphorylated tau (P-tau) are associated with delirium in hip fracture patients with and without dementia...
September 20, 2016: Journal of Alzheimer's Disease: JAD
Alessandro Morandi, Daniel Davis, Giuseppe Bellelli, Rakesh C Arora, Gideon A Caplan, Barbara Kamholz, Ann Kolanowski, Donna Marie Fick, Stefan Kreisel, Alasdair MacLullich, David Meagher, Karen Neufeld, Pratik P Pandharipande, Sarah Richardson, Arjen J C Slooter, John P Taylor, Christine Thomas, Zoë Tieges, Andrew Teodorczuk, Philippe Voyer, James L Rudolph
Delirium occurring in patients with dementia is referred to as delirium superimposed on dementia (DSD). People who are older with dementia and who are institutionalized are at increased risk of developing delirium when hospitalized. In addition, their prior cognitive impairment makes detecting their delirium a challenge. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and the International Statistical Classification of Diseases and Related Health Problems, 10th Revision are considered the standard reference for the diagnosis of delirium and include criteria of impairments in cognitive processes such as attention, additional cognitive disturbances, or altered level of arousal...
September 16, 2016: Journal of the American Medical Directors Association
Clay Angel, Kristen Brooks, Julie Fourie
CONTEXT: Delirium is common among inpatients aged 65 years and older and is associated with multiple adverse consequences, including increased length of stay (LOS). However, delirium is frequently unrecognized and poorly understood. At one hospital, baseline management of delirium on medical-surgical units varied greatly, and psychiatric consultations focused exclusively on crisis management. OBJECTIVE: To implement a multidisciplinary program for rapid identification and proactive management of patients with delirium on medical-surgical units...
September 9, 2016: Permanente Journal
Peter Hartley, Kerry Alexander, Jennifer Adamson, Carol Cunningham, Georgina Embleton, Roman Romero-Ortuno
AIM: Impaired cognition is common among older patients admitted to acute hospitals, but its association with functional trajectories has not been well studied. METHODS: A retrospective observational study was carried out in an English tertiary university hospital. We analyzed all first episodes of county residents aged ≥75 years admitted to the Department of Medicine for the Elderly wards between December 2014 and May 2015. A history of dementia or a cognitive concern in the absence of a known diagnosis of dementia were recorded on admission...
September 16, 2016: Geriatrics & Gerontology International
L Bonanni, A Cagnin, F Agosta, C Babiloni, B Borroni, M Bozzali, A C Bruni, M Filippi, D Galimberti, R Monastero, C Muscio, L Parnetti, D Perani, L Serra, V Silani, P Tiraboschi, A Padovani
Dementia with Lewy bodies (DLB) causes elevated outlays for the National Health Systems due to high institutionalization rate and patients' reduced quality of life and high mortality. Furthermore, DLB is often misdiagnosed as Alzheimer's disease. These data motivate harmonized multicenter longitudinal cohort studies to improve clinical management and therapy monitoring. The Italian DLB study group of the Italian Neurological Society for dementia (SINdem) developed and emailed a semi-structured questionnaire to 572 national dementia centers (from primary to tertiary) to prepare an Italian large longitudinal cohort...
September 13, 2016: Neurological Sciences
Andrew H Ford
Delirium is a common, disabling medical condition that is associated with numerous adverse outcomes. A number of inter-related factors, including pre-existing cognitive impairment, usually contribute to the development of delirium in a particular susceptible individual. Non-pharmacological approaches to prevention typically target multiple risk factors in a systematic manner (multicomponent interventions). There is generally good evidence that multicomponent interventions reduce the incidence of delirium in hospital populations but there are limited data in people with dementia and those living in the community...
October 2016: Maturitas
George J E Crowther, Michael I Bennett, John D Holmes
INTRODUCTION: in the United Kingdom dementia is generally diagnosed by mental health services. General hospitals are managed by separate healthcare trusts and the handover of clinical information between organisations is potentially unreliable. Around 40% of older people admitted to hospital have dementia. This group have a high prevalence of psychological symptoms and delirium. If the dementia diagnosis or symptoms are not recognised, patients may suffer unnecessarily with resulting negative outcomes...
September 10, 2016: Age and Ageing
Martin G Cole, Jane McCusker, Robert Bailey, Michael Bonnycastle, Shek Fung, Antonio Ciampi, Eric Belzile
BACKGROUND: the implications of partial and no recovery from delirium after hospital discharge are not clear. We sought to explore whether partial and no recovery from delirium among recently discharged patients predicted increased adverse events (emergency room visits, hospitalisations, death) during the subsequent 3 months. METHOD: prospective study of recovery from delirium in older hospital inpatients. The Confusion Assessment Method was used to diagnose delirium in hospital and determine recovery status after discharge (T0)...
September 8, 2016: Age and Ageing
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