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Center on Aging Continuing Education for Health Care Professionals
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DELIRIUM IN THE ELDERLY
Despite a high prevalence, and substantial morbidity and mortality, delirium, or an acute confusional state, is frequently misdiagnosed by physicians. Delirium occurs in 10 to 15% of hospitalized medical and surgical adult patients. Prevalence rates vary greatly, depending on the patient population: surgical (15 to 40%), critical care (20 to 40%), psychiatric and neurological (20 to 30%), or general medicine (15 to 20%). Recent studies report mortality rates from 15 to 30%. Other complications include falls, aspirations, pressure ulcers, immobility and dehydration. (Find out more)
DIAGNOSIS OF DEMENTIA
Dementia is a chronic impairment of intellectual functioning of sufficient severity to interfere with social or occupational functioning. Patients with dementia manifest multiple cognitive deficits manifested by memory impairment (impaired to learn new information or to recall previously learned information)and one (or more) of the following cognitive disturbances: aphasia (language disturbance), apraxia (impaired ability to carry out motor activities despite intact motor function), agnosia (failure to recognize or identify objects despite intact sensory function), and disturbance in executive functioning, (i.e., planning, organization, sequencing, abstracting). (Find out more)
DEPRESSION IN THE ELDERLY: A PRIMARY CARE PERSPECTIVE
Depression is one of the most frequent psychiatric problems experienced by older adults. When measured by criteria established by the American Psychiatric Association, the prevalence of a major depressive disorder is 4-5% in the elderly. However, perhaps as many as 20% of the elderly living in the community have some symptoms of depressive symptomatology. Depression is even higher among the elderly in hospitalized or nursing home populations: 12 to 23% in acute care and 15-30% in nursing homes. (Find out more)
TREATMENT OF DEMENTIA
In most instances, dementia is due to Alzheimer's or Multiple infarcts. In these patients, treatment is palliative rather than curative. However, over 30% of patients with dementia have more than one illness contributing to the dementia state. Treatment of these concomitant disorders provides temporary improvement in 28% of 200 patients and improvement is sustained for at least one year in 14%. Thus patients with irreversible dementia due to Alzheimer's and MID may improve in function with comprehensive management, although their cognitive status continues to inexorably deteriorate. (Find out more)

 

 

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