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Vitamin D and delirium

Gabriel Gold, Christophe Büla, Pierre Olivier Lang, Philippe Chassagne
2017 highlights benefits of prevention. Better control of cardiovascular risk reduces the incidence of dementia and monthly high-dose vitamin D the incidence of respiratory infections in nursing home. Pre-operative geriatric assessment lowers by 20% the rate of delirium after hip-fracture surgery and complications in vascular surgery. Deleterious effects are also reported. High-dose vitamin D triples the rate of falls in supplemented residents and doesn't improve gait speed in sedentary men. Widely used in cardiovascular prevention, antithrombotic therapy is associated with an astonishing risk of subdural bleeding that further increases with the number of drugs combined together...
January 10, 2018: Revue Médicale Suisse
Anthony Cahill, Christopher Pearcy, Khalid Almahmoud, Vaidehi Agrawal, Usha Mani, Phillip Sladek, Michael S Truitt
INTRODUCTION: Delirium has been well studied among patients in the intensive care unit (ICU); however, data beyond the ICU is limited. The purpose of this study is to prospectively evaluate the incidence and associated risk factors for delirium in noncritical care areas (NCCA). METHODS: After institutional review board approval, a prospective cohort study was conducted at our urban Level I Trauma Center from December 2015 to February 2016. All patients admitted to the designated study area by a trauma surgeon were included...
January 2018: Journal of Trauma and Acute Care Surgery
J M Fernández-Ibáñez, M C Morales-Ballesteros, E Crespo-Romero, S Gómez-Gómez, M D Fraga-Fuentes, J Cruz-Tejado, P A Hernández-Zegarra, Á Arias-Arias, M M García-Baltasar
AIM: To describe the orthogeriatric activity in the elderly with hip fractures in the Hospital Mancha Centro, based on the recommendations of the main guidelines. MATERIAL AND METHOD: Observational prospective study, comprising all patients over 65 years of age admitted to the Traumatology Unit with a hip fracture between April 2015 and December 2015. Patients were admitted under the care of the Traumatology Unit with cross-consultation carried out with the Geriatrics Department, which then carried out a pre-operative geriatric assessment and the post-operative follow-ups...
March 2017: Revista Española de Cirugía Ortopédica y Traumatología
Sadeq A Quraishi, Augusto A Litonjua, Kevin M Elias, Fiona K Gibbons, Edward Giovannucci, Carlos A Camargo, Kenneth B Christopher
The goal of the present study was to determine whether pre-hospital 25-hydroxyvitamin D (25(OH)D) levels are associated with the risk of hospital-acquired new-onset delirium (HANOD). We performed a retrospective cohort study of 4508 adult inpatients at two teaching hospitals in Boston from 1993 to 2006. All patients had 25(OH)D levels measured before hospital admission. The main outcome measure was HANOD, defined as the onset of delirium during an acute care hospitalisation. Patients with a history of delirium or dementia, or those with a diagnosis of delirium or dementia upon acute care hospitalisation were excluded from the analysis...
June 14, 2015: British Journal of Nutrition
Pedro Carpintero, Jose Ramón Caeiro, Rocío Carpintero, Angela Morales, Samuel Silva, Manuel Mesa
Nowadays, fracture surgery represents a big part of the orthopedic surgeon workload, and usually has associated major clinical and social cost implications. These fractures have several complications. Some of these are medical, and other related to the surgical treatment itself. Medical complications may affect around 20% of patients with hip fracture. Cognitive and neurological alterations, cardiopulmonary affections (alone or combined), venous thromboembolism, gastrointestinal tract bleeding, urinary tract complications, perioperative anemia, electrolytic and metabolic disorders, and pressure scars are the most important medical complications after hip surgery in terms of frequency, increase of length of stay and perioperative mortality...
September 18, 2014: World Journal of Orthopedics
James A Bourgeois, Ana Hategan, Jennifer Ford, Daniel K Tisi, Glen L Xiong
The authors examined the frequency of neuroimaging findings of cortical atrophy and/or cerebrovascular disease in patients with delirium with hypovitaminosis D and normal vitamin D levels. Of 32 patients with delirium with hypovitaminosis D who were neuroimaged, 91.4% had neuroimaging findings, despite only five cases having a comorbid diagnosis of dementia. Similar frequencies of cortical atrophy and/or cerebrovascular disease were found in patients with delirium with normal vitamin D levels. Further research with a larger sample size is needed to compare neuroimaging findings between normal patients and patients with hypovitaminosis D with delirium...
2015: Journal of Neuropsychiatry and Clinical Neurosciences
Jennifer Ford, Ana Hategan, James A Bourgeois, Daniel K Tisi, Glen L Xiong
BACKGROUND: As vitamin D may have a neuroprotective effect, the authors studied the association of biomarkers of vitamin D status and delirium to see if low vitamin D status was common in delirium cases. METHODS: Biochemical measures of vitamin D (25-hydroxyvitamin D [25-OHD]) and calcium metabolism were used in this retrospective cross-sectional analysis of adult in-patients with delirium, admitted at three Canadian academic hospitals from January 2011 to July 2012...
2013: Canadian Geriatrics Journal: CGJ
D Kibirige, C Wekesa, M Kaddu-Mukasa, M Waiswa
BACKGROUND: Vitamin B12 deficiency is associated with a wide spectrum of neuro-psychiatric manifestations. RESULTS: We report a case of a 44 year old female patient referred to the haematology unit with vitamin B12 deficiency presenting as an acute confusional state or delirium. Total resolution of the psychiatric symptoms occurred following parenteral vitamin B12 replacement therapy. CONCLUSION: This case report highlights one of the neuro-psychiatric presentations of vitamin B12 deficiency in a previously healthy individual...
September 2013: African Health Sciences
O Beauchet, C Launay, L de Decker, B Fantino, A Kabeshova, C Annweiler
OBJECTIVE: (1) To confirm that vitamin D deficiency, defined as serum 25-hydroxyvitamin D (25OHD) concentration < 25 nmol/L, was associated with long length-of-stay (LOS) among older inpatients admitted to geriatric acute care unit; and (2) to examine which combination of risk factors of longer LOS including vitamin D deficiency best predicted longer LOS. STUDY DESIGN AND SETTING: Based on a prospective cohort study with a 25-day follow-up on average, 531 consecutive older inpatients (mean age 85...
2013: Journal of Nutrition, Health & Aging
Isaura B Menzies, Daniel A Mendelson, Stephen L Kates, Susan M Friedman
Hip fractures and dementia increase exponentially with age, and patients who are afflicted by both conditions suffer significant morbidity and mortality. The aging of our population heightens the need to recognize the interaction of these conditions in order to improve our efforts to prevent hip fractures, provide acute care that improves outcomes, and provide secondary prevention and rehabilitation that returns patients to their previous level of functioning. Identification and treatment of vitamin D deficiency and osteoporosis and assessment and interventions to reduce falls in patients with dementia can significantly impact the incidence of first and subsequent hip fractures...
November 2010: Geriatric Orthopaedic Surgery & Rehabilitation
M I Lapid, M T Drake, J R Geske, C B Mundis, T L Hegard, S Kung, M A Frye
OBJECTIVES: This study investigated the rate of hypovitaminosis D in psychogeriatric inpatients and explored whether any associations exist between vitamin D levels, cognitive function, and psychiatric diagnoses. DESIGN: Retrospective medical record review from November 2000 through November 2010. SETTING: Geriatric psychiatric ward of an academic tertiary care hospital. PARTICIPANTS: Psychiatric inpatients aged 65 years or older...
March 2013: Journal of Nutrition, Health & Aging
Nicolas Gay, Olivier Lamy, Romaine Pouget
A 65 year old alcoholic man was hospitalized because he was tired, hypotonic, with postural tremor. The neurologic symptoms increased during the first two days despite an adequate therapy for alcoholic weaning with hydratation, benzodiazepines and vitamins. A severe hypophosphatemia is diagnosed, associated with hypovitaminosis D, mild hypomagnesemia, mild hypokaliemia and a refeeding syndrome. 24 hours after the normalisation of his phosphatemia, the neurologic symptoms are adjusted.
January 2, 2013: Praxis
Alessandro Morandi, Nicolas Barnett, Russel R Miller, Timothy D Girard, Pratik P Pandharipande, Eugene W Ely, L B Ware
PURPOSE: The pathophysiology of delirium in critical illness is unclear. 25-OH vitamin D (25-OHD) has neuroprotective properties but a relationship between serum 25-OHD and delirium has not been examined. We tested the hypothesis that low serum 25-OHD is associated with delirium during critical illness. MATERIALS AND METHODS: In a prospective cohort of 120 medical intensive care unit (ICU) patients, blood was collected within 24 hours of ICU admission for measurement of 25-OHD...
June 2013: Journal of Critical Care
Barbara Messinger-Rapport
Clinical trials in the past few years have yielded findings that are relevant for clinical practice, not just for geriatricians but for all physicians who have elderly patients.
November 2010: Cleveland Clinic Journal of Medicine
Karen Barnard, Cathleen Colón-Emeric
BACKGROUND: Vitamin D insufficiency is prevalent among older adults and may be associated with higher risk for cardiovascular (CV) disease, mortality, depression, and cognitive deficits. OBJECTIVE: The aim of this article was to review published observational and experimental studies that explored the association between vitamin D insufficiency and CV disease, mortality, mood, and cognition with an emphasis on older adults. METHODS: PubMed and Web of Science databases were searched for English-language articles from January 1966 through June 2009 relating to vitamin D, using the following MeSH terms: aged, vitamin D deficiency, physiopathology, drug therapy, cardiovascular diseases, blood pressure, mortality, delirium, dementia, cognitive disorders, depression, depressive disorder, seasonal affective disorder, mental disorders, and vitamin D/therapeutic use...
February 2010: American Journal of Geriatric Pharmacotherapy
C Annweiler, G Allali, P Allain, S Bridenbaugh, A-M Schott, R W Kressig, O Beauchet
Chronic low serum 25-hydroxyvitamin D (25OHD) concentrations are common in adults and are associated with numerous non-skeletal diseases. Vitamin D receptors (VDR) are located in the human cortex and hippocampus, which are key areas for cognition. The objective of this study was to systematically review all published data from the past 30 years which examined the association between serum 25OHD concentrations and cognitive performance in adults. An English and French Medline, PsycINFO and Cochrane Library search ranging from 1979 to 2008 indexed under the Medical Subject Heading (MeSH) terms 'Vitamin D' or 'Hydroxycholecalciferols' combined with the terms 'Dementia' or 'Cognition' or 'Cognition Disorders' or 'Delirium' or 'Memory' or 'Memory Disorders' or 'Orientation' or 'Executive Functions' or 'Attention' or 'Brain' or 'Neuropsychological Tests' was performed...
October 2009: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Julie A Switzer, Susan Jaglal, Earl R Bogoch
Indications for and benefits of providing osteoporosis (OP) care for hip fracture patients have become widely understood. The hip fracture patient is frequently over age 80 years, minimally ambulatory, has multiple medical comorbidities, and has cognitive impairment. Patient barriers to initiation of effective OP treatment include: age, dementia, medical comorbidities, polypharmacy, lack of adherence with treatment, alcohol abuse, postoperative delirium, language barriers, inadequate social support, and socioeconomic status...
July 2009: Journal of Orthopaedic Trauma
Barbara Messinger-Rapport, Linda G Dumas
Problem solving using a collaborative approach may reduce the risk of falls in the nursing home. Interventions need to be tailored to the individual's cognitive and physical impairments as well as be feasible in the particular long-term care setting. Polypharmacy, Vitamin D deficiency, delirium, and urinary incontinence are among several risks for falls that are discussed in this article.
June 2009: Nursing Clinics of North America
John E Morley
Falls occur commonly in older persons and are the seventh leading cause of death. Falls are associated with functional deterioration and "fear of falling". Falls can be due to extrinsic factors such as poor lighting, throw rugs and other environmental hazards. Intrinsic causes of falls include physiological changes associated with aging, orthostatic hypotension, many medications, delirium, anemia, diabetes mellitus, Parkinson's disease, depression, cognitive impairment, syncope, partial complex seizures and vitamin D deficiency...
January 2007: Missouri Medicine
George S Alexopoulos, Dilip V Jeste, Henry Chung, Daniel Carpenter, Ruth Ross, John P Docherty
OBJECTIVES: New treatment options for dementia and its behavioral disturbances have become available since publication of The Expert Consensus Guidelines on the Treatment of Agitation in Older Persons with Dementia in 1998. While only 2 cholinesterase inhibitors, donepezil and tacrine, were available in 1998, 3 new cognitive-enhancing agents have been introduced since that time as well as several new atypical antipsychotics and antidepressants. However, there are still limited data from controlled studies to guide clinicians in choosing among these agents and sequencing and combining treatments...
January 2005: Postgraduate Medicine
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