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26 Cards in this Set
- Front
- Back
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Define delirium
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Transient
Global Organic Mental syndrome disordered cognition attention disturbed psychomotor behaviour disturbed sleep-wake cycle DUE TO abnormal cerebral function |
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Clinical features of delirium
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Reduced alterness/attention
Disoriented/memory loss anxiety Fluctuation, noctural worsening Hallucinations/delusions Agitation unco-operative Rambling Tuned out Ill-sweating and tremor Hypo/hyperactive |
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Prevalence of delirium in mean general hospital population
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20%
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Common causes of delirium (4)
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UTI
Pneumonia HF stroke |
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Which drugs may be used in delirium if necessary
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Benzodiazepines
Haloperidol |
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Name 6 vulnerability factors for delirium
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Sensory impairment (eyes, ears)
Excessive pain Sleep deprevation Social Isolation Depression Dementia |
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what is the prevalence of depression in the eldely?
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10-15%
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What is the prevelence of depression in a residential home?
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25-30%
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What is the prevelence of depression in a nusing home?
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30-35%
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What is the prvelence of depression in post-stroke survivors?
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40-45%
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What proportion of completed suicides are in the elderly?
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1/3
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If depression is untreated it...
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shortens life
increases health care costs causes suicide compounds co-morbidities |
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Depression is over diagnosed in the elderly.
T/F? |
F - poor detection and sub-optimal rx
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More common in depression in younger or older adults...
Altered sleep and appetite |
Older
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More common in depression in younger or older adults...
Bodily complaints |
Older
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More common in depression in younger or older adults...
Expressed suicidal intent |
Younger
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More common in depression in younger or older adults...
Irritability |
Younger
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More common in depression in younger or older adults...
Actual suicidal intent |
Older
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More common in depression in younger or older adults...
Delusions |
Older
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When is "don't know" said alot?
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Pseudo-dementia (depression)
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When to refer for specialist advice with an elderly patient with depression
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Diagnosis in doubt (dementia?)
Severe (Suicide risk, failure to eat/drink, psychotic) Complex therapy indicated Failure to Rx |
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Differential diagnosis of psychosis?
a) Acute b) Chronic |
a) Delirium
b) Primary psychotic disorder (chronic schizophrenia, late onset schizophrenia, affective disorder, delusional disorder), neurodegenerative disorder, chronic medical condition |
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Risk factors for psychosis in the eldely?
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Sensory defect
Isolation Conitive decline Sex (female) Age related decline (frontal/temporal cortices) Polypharmacy |
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Elderly people experience more negative sx in psychosis.
T/F? |
F - Fewer negative sx
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Elderly people have a better response to rx of psycosis.
T/F? |
T - got you!
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Mx of an elderly person with psychosis?
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RISK
Home/Day hospital/hospital Correct sensory impairment Alleviate social isolation Antipsychotic MDT support and follow-up Sx/insight/compliance Physical problems |
