Delirium (acute toxic confusion) in the elderly

2003 ◽  
Vol 2 (1) ◽  
pp. 19-24
Author(s):  
Claire Spice ◽  
◽  
Michael Bacon ◽  
Keyword(s):  
Differential Diagnosis ◽  
Elderly Patients ◽  
Clinical Features ◽  
The Elderly ◽  
Physical Problem ◽  
Acute Confusional State ◽  
Confusional State ◽  
The Common ◽  
Optimum Management ◽  
Acute Toxic

Delirium (also referred to as acute confusional state or toxic confusional state) is common in elderly patients admitted to hospital, and is usually secondary to an acute physical problem rather than being a primary abnormality. Physicians caring for acutely ill patients will frequently encounter those with delirium and need to be aware of the likely precipitants as well as the optimum management. We discuss the common precipitants, the clinical features, the differential diagnosis and the management of delirium.

Depression and dementia: A conspiracy ?

2011 ◽  
Vol 26 (S2) ◽  
pp. 2211-2211
Author(s):  
C. Hanon
Keyword(s):  
Differential Diagnosis ◽  
Cognitive Functioning ◽  
Elderly Population ◽  
The Elderly ◽  
Scientific Data ◽  
The Other ◽  
Comorbid Depression ◽  
Adequate Treatment ◽  
Treatment Of Depression ◽  
The Common

Depression and dementia are two very common clinical entities in the elderly population. Differential diagnosis of these disorders may pose difficulties. On the other hand, when they are comorbid, depression and dementia may affect the outcome of each other. When adequate treatment for depression is provided, patients with dementia may experience a significant improvement in cognitive functioning. Therefore, the possibility of comorbid depression and dementia should always be taken into account in the elderly population. This presentation will address the common clinical obstacles encountered while managing these disorders. Using the latest scientific data, the adequate treatment of depression and dementia will be discussed.

scholarly journals Use of atorvastatin on pacients with chronic subdural haematoma: an integrative review

2021 ◽  
Author(s):  
Nathan Isaac Grassi Evangelista ◽  
Matheus Antonio Traldi ◽  
Bianca de Oliveira Sousa ◽  
Emanuella Campaner Zanotti ◽  
Arthur Dal Fabbro Chocair ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Surgical Intervention ◽  
Chronic Subdural Hematoma ◽  
The Elderly ◽  
Chronic Subdural Haematoma ◽  
Integrative Review ◽  
Neurological Deficits ◽  
Atorvastatin Treatment ◽  
Effect Of Treatment ◽  
The Common

Background: Chronic subdural hematoma (CSDH) tends to occur more commonly in elderly patients, usually develops after mild head trauma and the common treatment is surgical. Objective: To evaluate the effect of treatment with atorvastatin compared to surgical intervention in elderly people with CSDH. Design and setting: we performed an integrative review of studies available in four databases from 2010 to 2020. Methods: Studies were considered eligible for this review if they were randomized controlled trials comparing the use of atorvastatin treatment to surgical treatment associated with drainage trepanation in elderly patients diagnosed with CSDH. Results: titles and abstracts were screened and 20 articles of those were selected to be fully read, of which 4 remained. To Sheng Qui et al (2017) and Chan et al (2016), the use of atorvastatin may be beneficial in the management of CSDH, so that the volume of the hematoma reduced from 48.70 ± 20.38 to 16.64 ± 14.28mL with a sample size of 22 in the first month of oral atorvastatin. Min Xu et al. (2016) and Wang et al. (2013), with a sample of 22, found improvements in 85.7% and 95.7% of patients with CSDH in terms of volume and neurological deficits presented. Conclusion: The treatment with atorvastatin appears to be safe and effective for CSDH compared to surgical intervention in the elderly. However, further studies are necessary to validate the results and, thus, to put the evidence into practice.

scholarly journals Clinical characterization and risk factors of Clostridium difficile infection in elderly patients in a Chinese hospital

2015 ◽  
Vol 9 (04) ◽  
pp. 381-387 ◽  
Author(s):  
Zhang Lihua ◽  
Dong Danfeng ◽  
Jiang Cen ◽  
Wang Xuefeng ◽  
Peng Yibing
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Elderly Patients ◽  
Clinical Features ◽  
Clostridium Difficile Infection ◽  
Gastrointestinal Disease ◽  
Statistical Tests ◽  
The Elderly ◽  
Hospitalized Patients ◽  
Elderly Hospitalized Patients

Introduction: Clostridium difficile is a common cause of nosocomial diarrhea, especially in elderly patients. This study aimed to analyze the clinical features and assess the risk factors associated with Clostridium difficile infection (CDI) in elderly hospitalized patients. Methodology: A retrospective case-control study was conducted among elderly hospitalized patients (> 60 years of age) in a Chinese tertiary hospital between 2010 and 2013. Fifty-two CDI patients and 150 randomly selected non-CDI patients were included in the study. Clinical features of CDI and non-CDI patients were compared by appropriate statistical tests. Logistic regression analyses were performed on a series of factors to determine the risk factors for CDI among the elderly hospitalized patients. Results: The elderly CDI patients showed higher leukocyte counts, lower serum albumin levels, longer duration of hospital stay, and higher mortality compared to the non-CDI patients. The proportion of patients admitted to the intensive care unit or exposed to gastric acid suppressants was also significantly different (p < 0.05) between the two groups. Multivariate analysis indicated that serum creatinine (OR 1.004; 95% CI 1.001–1.008), surgical intervention (OR 6.132; 95% CI 2.594–14.493), the number of comorbidities (OR 2.573; 95% CI 1.353–4.892), gastrointestinal disease (OR 4.670; 95% CI 2.002–10.895), and antibiotic use (OR 6.718; 95% CI 2.846–15.859) were independently associated with CDI. Conclusions: This study revealed several risk factors for CDI among elderly hospitalized patients. These findings will increase the knowledge concerning this disease and provide information regarding the control and prevention of CDI in the elderly.

Changes in Pharmacokinetics and Pharmacodynamics in the Elderly Patient

2007 ◽  
Vol 20 (1) ◽  
pp. 4-12 ◽  
Author(s):  
Lisa C. Hutchison ◽  
Catherine E. O'Brien
Keyword(s):  
Elderly Patient ◽  
Elderly Patients ◽  
The Elderly ◽  
Pharmacokinetic Parameters ◽  
Beers Criteria ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Drug Dosing ◽  
Central Nervous System Agents ◽  
The Common ◽  
Pharmacologic Agents

The use of pharmacologic agents in elderly patients is one of the most difficult aspects of patient care. An understanding of the common physiologic changes expected with aging is helpful to anticipate changes expected in pharmacokinetic parameters. Distribution, metabolism, and excretion are significantly altered for many drugs. In addition, pharmacodynamic variations in elderly patients may increase or decrease sensitivity to a medication independent of pharmacokinetic changes. These alterations are particularly noteworthy with cardiovascular and central nervous system agents. Current controversies regarding the application of estimation of renal function to drug dosing and use of the Beers criteria of medications potentially inappropriate in the elderly are discussed.

Risperidone in the Treatment of Acute Confusional State (Delirium) Due to Neuropsychiatric Lupus Erythematosus: Case Report

2003 ◽  
Vol 33 (3) ◽  
pp. 299-303 ◽  
Author(s):  
Katsuji Nishimura ◽  
Masako Omori ◽  
Naoshi Horikawa ◽  
Eiichi Tanaka ◽  
Takefumi Furuya ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Atypical Antipsychotics ◽  
Acute Confusional State ◽  
Systemic Lupus ◽  
Confusional State ◽  
Drug Induced ◽  
Neuropsychiatric Sle ◽  
Neuropsychiatric Manifestations ◽  
The Common ◽  
Low Incidence

Acute confusional state (delirium) appears as one of the common neuropsychiatric manifestations of systemic lupus erythematosus (SLE). It has been suggested that neuropsychiatric SLE (NP-SLE) could promote the occurrence of drug-induced extrapyramidal symptoms (EPS). Atypical antipsychotics have been thought to be useful in management of delirium because of their low incidence of adverse effects including EPS. However, no reports of the use of atypical antipsychotics in delirium due to NP-SLE have been published. Here we report a case of NP-SLE presenting an acute confusional state (delirium), which was successfully managed by risperidone.

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