Prevalence of paranoid symptomatology in the elderly and relationship to organic brain factors

2011 ◽  
Vol 26 (S2) ◽  
pp. 853-853
Author(s):  
M. Serrano Díaz de Otálora ◽  
J. Gómez-Arnau Ramírez ◽  
R. Martínez de Velasco ◽  
P. Artieda Urrutia
Keyword(s):  
Cognitive Impairment ◽  
Black People ◽  
The Elderly ◽  
Delusional Disorder ◽  
Psychotic Symptoms ◽  
Medical Conditions ◽  
Paranoid Symptoms ◽  
Organic Brain ◽  
The Many

IntroductionPsychotic diseases in the elderly are underdiagnosed due to the limited use of medical resources. Advanced age makes psychoses of any cause less pure and differentiated, since old age adds a cognitive-impairment component to the basal psychotic defect.ObjectivesWe intend to estimate the prevalence of paranoid symptoms in older patients, and to study the many medical conditions associated with psychosis.MethodsWe conducted a literature review and we have performed a review of several clinical trials.ResultsWe found 12.1% of paranoid symptoms in the elderly with cognitive impairment. In absence of this factor, we found a prevalence of 14.1% for suspicion tendencies, 6.9% for paranoid thoughts and 5.5% for evident delusions. These figures were significantly higher in old black people.We present a table of the main medical conditions that can produce psychotic symptoms. Some cases of apparently typical delusional disorder can appear as a long-term complication of some of these diseases. If organic factors are subtle and long lasting, the clinical may reproduce a fairly typical delusional disorder and may respond to treatment with neuroleptic drugs.ConclusionsIt seems possible that organic brain factors are more common that we believe, becoming essential a comprehensive study of the old psychotic patient. We should pay more attention to psychotic symptoms in elderly patients and avoid conclusions based on cross-evaluations. Diagnosis will be defined by evolution in most of the cases.

scholarly journals A Case Report of Severe Delirium after Amantadine Withdrawal

2017 ◽  
Vol 9 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Franz Marxreiter ◽  
Jürgen Winkler ◽  
Martin Uhl ◽  
Dominik Madžar
Keyword(s):  
Cognitive Impairment ◽  
Case Report ◽  
Withdrawal Syndrome ◽  
Dopamine Agonists ◽  
Psychotic Symptoms ◽  
Drug Induced ◽  
Comt Inhibitors ◽  
Mao B ◽  
Psychotropic Substance

Amantadine is frequently used in addition to dopaminergic substances like dopamine agonists or L-Dopa in advanced Parkinson disease (PD). However, adverse effects like hallucinations limit its use. PD patients developing severe psychotic symptoms upon treatment with either dopaminergic substances and/or amantadine need to stop intake of any psychotropic substance. Here, we report the case of a 71-year-old PD patient without previously known cognitive impairment. He presented with drug-induced psychotic symptoms due to changes in his therapeutic regimen (increase in COMT inhibitors, newly introduced MAO B inhibitors). Also, amantadine had been part of his long-term medication for more than 2 years. The severity of his psychotic symptoms required a L-Dopa monotherapy. After changing his medication, the patient developed severe delirium that resolved rapidly after i.v. amantadine infusion, suggesting an amantadine withdrawal syndrome. Amantadine withdrawal syndrome is a rare adverse event that may present even in PD patients without cognitive impairment. This case report highlights the need for a gradual withdrawal of amantadine even if acute and severe psychotic symptoms are present. Moreover, this is the first report of a cognitively unimpaired patient developing an amantadine withdrawal syndrome.

scholarly journals Long-lasting rescue of schizophrenia-relevant cognitive impairments via risperidone-loaded microPlates

2022 ◽  
Author(s):  
Elena Bellotti ◽  
Gabriella Contarini ◽  
Federica Geraci ◽  
Sebastiano Alfio Torrisi ◽  
Cateno Piazza ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mouse Model ◽  
Sustained Release ◽  
Temporal Order ◽  
Single Injection ◽  
Chronic Administration ◽  
Psychotic Symptoms ◽  
Residual Rate ◽  
Long Acting

AbstractSchizophrenia is a disorder characterized by cognitive impairment and psychotic symptoms that fluctuate over time and can only be mitigated with the chronic administration of antipsychotics. Here, we propose biodegradable microPlates made of PLGA for the sustained release of risperidone over several weeks. Two microPlate configurations – short: 20 × 20 × 10 μm; tall: 20 × 20 × 20 μm – are engineered and compared to conventional ~ 10 μm PLGA microspheres in terms of risperidone loading and release. Tall microPlates realize the slowest release documenting a 35% risperidone delivery at 100 days with a residual rate of 30 ng/ml. Short microPlates and microspheres present similar release profiles with over 50% of the loaded risperidone delivered within the first 40 days. Then, the therapeutic efficacy of one single intraperitoneal injection of risperidone microPlates is compared to the daily administration of free risperidone in heterozygous knockout mice for dysbindin-1, a clinically relevant mouse model of cognitive and psychiatric liability. In temporal order object recognition tasks, mice treated with risperidone microPlates outperform those receiving free risperidone up to 2, 4, 8, and 12 weeks of observation. This suggests that the sustained release of antipsychotics from one-time microPlate deposition can rescue cognitive impairment in dysbindin mice for up to several weeks. Overall, these results demonstrate that risperidone-loaded microPlates are a promising platform for improving cognitive symptoms associated to schizophrenia. Moreover, the long-term efficacy with one single administration could be of clinical relevance in terms of patient’s compliance and adherence to the treatment regimen. Graphical abstract Single injection of long-acting risperidone-loaded µPL ameliorates the dysbindin-induced deficit in a clinically relevant mouse model of cognitive and psychiatric liability for up to 12 weeks

scholarly journals Factors associated with the institutionalization of the elderly: a case-control study

2016 ◽  
Vol 19 (6) ◽  
pp. 1004-1014 ◽  
Author(s):  
Ezequiel Vitório Lini ◽  
Marilene Rodrigues Portella ◽  
Marlene Doring
Keyword(s):  
Cognitive Impairment ◽  
Elderly People ◽  
Daily Living ◽  
Long Term Care ◽  
The Elderly ◽  
Case Control ◽  
Term Care ◽  
Factors Associated ◽  
Care Facilities

Abstract Objective: to identify the factors associated with the institutionalization of the elderly. Method: a case-control, population-based study was performed with 387 elderly people. The study considered cases of elderly people (n=191) living in long-term care facilities, and a control group (n=196) who lived in homes in urban areas of the city. Both groups were identified from the records of the Family Health Strategy and were randomly selected. Institutionalization was considered a dependent variable, and sociodemographics, clinical factors, functional status, and cognitive impairment were considered independent variables. Comparison between groups was analyzed using the Chi-squared and Pearson tests and the logistic regression model was used in adjusted analysis, with measurements of effect expressed as odds ratio with a 95% confidence interval. Variables with p≤0.20 were considered for entry in the multiple model. Results: variables that remained associated with institutionalization in multiple analysis were: not having a partner (OR=9.7), not having children (OR=4.0), presenting cognitive impairment (OR=11.4), and depending on others to perform basic activities of daily living (OR=10.9). Conclusion: cognitive impairment and dependency for basic activities of daily living were more strongly associated with institutionalization. Home care strategies and preventive actions for risk factors should be stimulated to delay the referral of elderly people to Long Term Care Facilities for the Elderly, and to develop strategies that allow the elderly to remain socially active.

An estimate of the prevalence of dementia among residents of long-term care geriatric institutions in the Jerusalem area

2006 ◽  
Vol 18 (4) ◽  
pp. 643-652 ◽  
Author(s):  
Helena Feldman ◽  
A. Mark Clarfield ◽  
Jenny Brodsky ◽  
Yaron King ◽  
Tzvi Dwolatzky
Keyword(s):  
Cognitive Impairment ◽  
Medical Records ◽  
Long Term Care ◽  
The Elderly ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Term Care ◽  
Prevalence Of Dementia

Background: To determine the prevalence of dementia among the residents of geriatric institutions in the greater Jerusalem area.Methods: A population-based, cross-sectional survey of a representative sample, weighted according to the level of care, of 11 of the 88 long-term care (LTC) wards in 34 LTC institutions providing care for the elderly residents in the greater Jerusalem area in 1999. A single physician interviewed 311 residents. The presence of dementia was determined from medical records and by performance on the Modified Mini-mental State Examination (3MS) instrument (with a score less than 78/100 indicating significant cognitive impairment or suspected dementia), and professional care providers were interviewed for their opinion regarding the presence of dementia in each subject.Results: The mean age of the patients was 83.9 years and 75% were women. Overall, 180 residents, representing 49.9% of the weighted sample in Jerusalem LTC facilities, were determined to have dementia according to medical records, ranging from 22.9% in independent and frail care units to 97.7% in skilled nursing care wards. However, based on their performance on the 3MS, the prevalence of cognitive impairment with suspected dementia among the subjects was substantially greater, with the staff being unaware of this diagnosis in about one-quarter of the subjects.Conclusions: There is a high prevalence of dementia in geriatric institutions in the Jerusalem area, particularly in those providing greater care. Moreover, significant cognitive impairment is probably under-reported in the medical records.

Long-Term Exposure to Traffic-Related Air Pollution and Mild Cognitive Impairment in the Elderly

Epidemiology ◽  
2009 ◽  
Vol 20 ◽  
pp. S22 ◽  
Author(s):  
Ulrich Ranft ◽  
Tamara Schikowski ◽  
Dorothee Sugiri ◽  
Jean Krutmann ◽  
Ursula Kraemer
Keyword(s):  
Air Pollution ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
The Elderly

scholarly journals Post-infection cognitive impairments in a cohort of elderly patients with COVID-19

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yu-Hui Liu ◽  
Ye-Ran Wang ◽  
Qing-Hua Wang ◽  
Yang Chen ◽  
Xian Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Elderly Patients ◽  
Cognitive Decline ◽  
Post Infection ◽  
Elderly Population ◽  
The Elderly ◽  
Cognitive Status ◽  
Increased Risk

Abstract Background Understanding the long-term effects of coronavirus disease 2019 (COVID-19) on cognitive function is essential for monitoring the cognitive decline in the elderly population. This study aims to assess the current cognitive status and the longitudinal cognitive decline in elderly patients recovered from COVID-19. Methods This cross-sectional study recruited 1539 COVID-19 inpatients aged over 60 years who were discharged from three COVID-19-designated hospitals in Wuhan, China, from February 10 to April 10, 2020. In total, 466 uninfected spouses of COVID-19 patients were selected as controls. The current cognitive status was assessed using a Chinese version of the Telephone Interview of Cognitive Status-40 (TICS-40) and the longitudinal cognitive decline was assessed using an Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Cognitive assessments were performed 6 months after patient discharge. Results Compared with controls, COVID-19 patients had lower TICS-40 scores and higher IQCODE scores [TICS-40 median (IQR): 29 (25 to 32) vs. 30 (26 to 33), p < 0.001; IQCODE median (IQR): 3.19 (3.00 to 3.63) vs. 3.06 (3.00 to 3.38), p < 0.001]. Severe COVID-19 patients had lower TICS-40 scores and higher IQCODE scores than non-severe COVID-19 patients [TICS-40 median (IQR): 24 (18 to 28) vs. 30 (26 to 33), p < 0.001; IQCODE median (IQR): 3.63 (3.13 to 4.31) vs. 3.13 (3.00 to 3.56), p < 0.001] and controls [TICS-40 median (IQR): 24 (18 to 28) vs. 30 (26 to 33), p < 0.001; IQCODE median (IQR) 3.63 (3.13 to 4.31) vs. 3.06 (3.00 to 3.38), p < 0.001]. Severe COVID-19 patients had a higher proportion of cases with current cognitive impairment and longitudinal cognitive decline than non-severe COVID-19 patients [dementia: 25 (10.50 %) vs. 9 (0.69 %), p < 0.001; Mild cognitive impairment (MCI): 60 (25.21 %) vs. 63 (4.84 %), p < 0.001] and controls [dementia: 25 (10.50 %) vs. 0 (0 %), p < 0.001; MCI: 60 (25.21 %) vs. 20 (4.29 %), p < 0.001)]. COVID-19 severity, delirium and COPD were risk factors of current cognitive impairment. Low education level, severe COVID-19, delirium, hypertension and COPD were risk factors of longitudinal cognitive decline. Conclusions Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with an increased risk of long-term cognitive decline in elderly population. COVID-19 patients, especially severe patients, should be intensively monitored for post-infection cognitive decline.

scholarly journals Cognitive performance of long-term institutionalized elderly patients with schizophrenia: A case control study

2011 ◽  
Vol 5 (2) ◽  
pp. 99-103 ◽  
Author(s):  
Alexandre Paim Diaz ◽  
Monica Zavaloni Scalco ◽  
Marcelo Libório Schwarzbold ◽  
Douglas Affonso Formolo ◽  
Alberto Stoppe Júnior
Keyword(s):  
Cognitive Impairment ◽  
Elderly Patients ◽  
Cognitive Performance ◽  
The Elderly ◽  
Psychiatric Diseases ◽  
Institutionalized Elderly ◽  
History Of ◽  
Language Abstraction ◽  
Institutionalized Patients

Abstract Cognitive impairment is inherent to the ageing process. Several studies suggest that patients with late-life schizophrenia have more marked cognitive impairment. Objective: The aim of this study was to compare the cognitive performance of elderly institutionalized patients with schizophrenia and institutionalized elderly control patients without neurological or psychiatric diseases, matched for age, educational level and institutionalization time. Methods: The Cambridge Examination for Mental Disorders of the Elderly (CAMCOG) was used to test 10 institutionalized elderly patients with schizophrenia. Results were compared with those of 10 institutionalized control patients with history of Hansen's disease. Results: Patients with schizophrenia showed a worse performance in terms of total CAMCOG score and on its subtests of orientation, language, abstraction, and memory (p≤0.05). Patients with schizophrenia also disclosed a non-significant trend toward lower scores on the MMSE and on calculus. Conclusion: Findings demonstrated that schizophrenia was associated to worse cognitive impairment in long-term institutionalized elderly patients compared with institutionalized patients without neurological or psychiatric diseases.

The Effect of Cognitive Impairment in the Elderly on the Initial and Long-Term Stability of Warfarin Therapy

Drugs & Aging ◽  
2012 ◽  
Vol 29 (4) ◽  
pp. 307-317 ◽  
Author(s):  
Hanan S. Khreizat ◽  
Peter Whittaker ◽  
Kristy D. Curtis ◽  
Gerald Turlo ◽  
Candice L. Garwood
Keyword(s):  
Cognitive Impairment ◽  
Warfarin Therapy ◽  
The Elderly ◽  
Term Stability ◽  
Long Term Stability

scholarly journals Supersensitivity Psychosis and Its Response to Asenapine in a Patient with Delusional Disorder

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Ravi Philip Rajkumar
Keyword(s):  
Atypical Antipsychotics ◽  
Antipsychotic Agents ◽  
Delusional Disorder ◽  
Auditory Hallucinations ◽  
Psychotic Symptoms ◽  
Antipsychotic Treatment ◽  
Typical Antipsychotic ◽  
Persecutory Delusions ◽  
Established Treatment

Supersensitivity psychosis is a recognized complication of long-term antipsychotic treatment, in which patients develop new or reemergent psychotic symptoms, generally accompanied by dyskinetic movements, due to prolonged dopamine receptor blockade and resultant supersensitivity. Though it is most closely associated with schizophrenia and the use of typical antipsychotic agents, it has also been documented in patients with other diagnoses, and in those receiving atypical antipsychotics. There is no established treatment for this condition. In this paper, we describe a patient with persistent delusional disorder, jealous type, who developed a supersensitivity psychosis characterized by persecutory delusions, auditory hallucinations, and thought insertion in association with mild tardive dyskinesia. These symptoms resolved completely following six weeks of treatment with the second-generation antipsychotic asenapine, 20 mg/day. The mechanisms and implications of the patient’s symptomatology and response are discussed.

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