Acute confusional States in the elderly--diagnosis and treatment.
Dtsch Arztebl Int. 2012 May;109(21):391-9;Source
Clinic and Policlinic for Neurology, Großhadern clinic, Ludwig Maximilian University of Munich, Germany. Stefan.Lorenzl@med.uni-muenchen.deAbstract
BACKGROUND:
Delirium is common, has multiple causes and causes distress to numerous patients and their relatives.METHOD:
Selective review of the literature in PubMed and PsycINFO, with reference to selected national and international guidelines.RESULTS:
The
hypoactive subtype of delirium is commoner than the hyperactive type,
and often overlooked. Delirium in an elderly individual is associated
with an additional burden, a possible loss of potential for
rehabilitation, and a marked increase in mortality. The diagnosis of
delirium is primarily clinical. All professionals involved in patient
care must be able to recognize the features of delirium. Dementia,
dehydration and polypharmacy are particularly strongly associated, in
the elderly.
A careful history and examination with appropriate
investigation allows underlying causes to be detected and treated.
Rehabilitation strategies should be initiated without delay.
Neuroleptics and benzodiazepines have an established role
in the pharmacological treatment even of the hyperactive subtype.
Non-pharmacological treatments include the creation of a calm and
patient centred environment, and the involvement of relatives.
CONCLUSION:
In many cases, delirium can be diagnosed and treated in good time. Prevention is preferable to treatment.Comment in
- In reply: Echocardiography is not a basic diagnostic test. [Dtsch Arztebl Int. 2013]
- Eliminate noxious agents acting as triggers. [Dtsch Arztebl Int. 2013]
- Echocardiography is not a basic diagnostic test. [Dtsch Arztebl Int. 2013]
No comments:
Post a Comment