Geriatric Syndromes Pt2 GERO495

•It is a neuropsychiatric syndrome called acute confusional state or acute brain failure that is common among the medically ill and often misdiagnosed as a psychiatric illness that can delay appropriate medical intervention.

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•There is significant mortality associated withdelirium so identifying it is crucial!

Delirium

•The patient is hyperactive, combative,and uncooperative

•May appear to be responding to internal stimuli

•Frequently these patients come todoctors’ attention because they aredifficult to manage

Hyperactive/hyperalert

•The patient appears to be napping onand off throughout the day

•Unable to sustain attentionwhen awakened, quicklyfalling back asleep

•Misses meals, medications,appointments

•Does not ask for care or attention

•This type is easy to miss becausecaring for these patients is notproblematic to staff

Hypoactive/Hypoalert

It is a combination of both hypoactive and hyperactive delirium

Mixed Delirium

Infections

•Electrolyte abnormalities

•Endocrine dysfunctions

•Liver failure- hepaticencephalopathy

•Renal failure- uremicencephalopathy

Systemic conditions

Dementia has an insidious onset, chronic memory, and executive functiondisturbance, and tends not to fluctuate.

In delirium, cognitive changes developacutely and fluctuate

Dementia has intact alertness andattention but impoverished speech andthinking.

Dementia has an insidious onset, chronic memory, and executive functiondisturbance, and tends not to fluctuate.

In delirium, cognitive changes developacutely and fluctuate

Dementia has intact alertness andattention but impoverished speech andthinking.

In delirium, speech can be confused or disorganized. Alertness and attention wax and wane

Dementia & Delirium differences

defined as the involuntary leakage of urine, is a common and distressing condition among older adults. Its prevalence rises with age and increasing frailty, and it is observed to be 1.3 to 2.0 times more frequent in older women compared to older men.

Urinary incontinence