Center on Aging Continuing
Education for Health Care Professionals |
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DELIRIUM
IN THE ELDERLY
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| 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) |
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DIAGNOSIS
OF DEMENTIA
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| 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) |
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DEPRESSION
IN THE ELDERLY: A PRIMARY CARE PERSPECTIVE
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| 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) |
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TREATMENT OF DEMENTIA
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| 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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