RT Book, Section
A1 Kane, Robert L.
A1 Ouslander, Joseph G.
A1 Resnick, Barbara
A1 Malone, Michael L.
SR Print(0)
ID 1149536136
T1 Delirium and Dementia
T2 Essentials of Clinical Geriatrics, 8e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9781259860515
LK accessmedicine.mhmedical.com/content.aspx?aid=1149536136
RD 2024/04/19
AB Diagnosis  and  management  of  geriatric  patients  exhibiting  symptoms  and  signs  of  impaired  cognitive  functioning  can  make  a  critical  difference  to  their  overall  health  and  their  ability  to  function  independently.  Impaired  cognitive  function  can  be  acute  in  onset,  or  it  can  be  slowly  progressive.  The  major  causes  of  impaired  cognition  in  the  geriatric  population  are  delirium  and  dementia.  As  more  people  live  into  the  tenth  decade  of  life,  the  chance  that  they  will  develop  some  form  of  dementia  increases  substantially.  Community-based  studies  report  a  prevalence  of  dementia  as  high  as  47%  among  those  85  years  of  age  and  older.  Recent  evidence  suggests  that  the  incidence  of  dementia  is  decreasing  in  more  recent  cohorts  of  people  studied  (Larson  et  al,  2013;  Satizabal  et  al,  2016).  Between  25%  and  40%  of  older  patients  admitted  to  acute  care  medical  and  surgical  services  are  delirious  on  admission  or  develop  delirium  during  their  hospital  stay.  In  nursing  homes,  50%  to  80%  of  those  older  than  65  years  of  age  have  some  degree  of  cognitive  impairment  which  can  range  from  mild  cognitive  deficits  to  end-stage  dementia.  Dementia  is  a  major  risk  factor  for  delirium,  and  delirium  is  often  superimposed  on  dementia  in  both  hospital  and  community  settings,  can  persist  for  days  to  weeks  after  discharge  from  an  acute  hospital,  and  is  a  risk  factor  for  functional  decline  and  mortality.  Both  dementia  and  delirium  are  associated  with  high  health-care  costs  (Amjad  et  al,  2016;  Okie,  2011).