HLTH201 Lecture Notes - Lecture 9: Hypervigilance, Prodrome, Dementia
6 Sep 2018
School
Department
Course
Professor
Document Summary
It is the biggest, most classic geriatric syndrome there is. Delirium is a syndrome, related to being sick, fluctuates but often gets better: but still, people with dementia often are delirious. Prodrome: develops over hours to days: restlessness, sleep disturbance, anxiety, irritability, subjective difficulty thinking. Inability to focus or shift attention: global impairment of attention and concentration. Fluctuates from hyper- to hypoactive throughout the day. Psychosis: affects up to 90% of people, delusions of persecution, hallucinations (visual, auditory, tactile, threatening, poorly articulated and fluctuate. Fluctuation: symptoms wax and wane during day, may even have lucid intervals, sundown: worse in evening, night, particularly psychosis, may reflect changes in sensory stimulation from environment. How common is this: elderly medical inpatients. Systematic review: prospective cohort + cross-sectional studies using dsm or similar criteria. 3-29% in-hospital incidence (13 studies: terminal illness: 80, community, nursing home ?, morality from delirium is- 25%
