The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
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Am J Geriatr Psychiatry · Jan 1998
The association of serum anticholinergic activity with delirium in elderly medical patients.
To investigate the hypothesis that elevated serum anticholinergic activity is independently associated with delirium in ill elderly persons, the authors performed a cross-sectional study of 67 acutely ill older medical inpatients. The presence of delirium was evaluated with the Confusion Assessment Method, and the presence of many delirium symptoms was measured by the Delirium Symptom Interview. ⋯ Logistic regression techniques demonstrated that elevated serum anticholinergic activity was independently associated with delirium. Among the subjects with delirium, a greater number of delirium symptoms was associated with higher serum anticholinergic activity.
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Am J Geriatr Psychiatry · Jan 1998
ReviewPsychosocial and behavioral interventions for Alzheimer's disease patients and their families.
In the absence of definitive treatments for Alzheimer's disease and related dementias, researchers in a variety of disciplines are developing psychosocial and behavioral intervention strategies to help patients and caregivers better manage and cope with the troublesome symptoms common in these conditions. These strategies include cognitive interventions, functional performance interventions, environmental interventions, integration of self interventions, and pleasure-inducing interventions. Although more research is needed to further develop these strategies and establish their best use, psychosocial and behavioral interventions hold great promise for improving the quality of life and well-being of dementia patients and their family caregivers.
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Am J Geriatr Psychiatry · Jan 1998
Occurrence and predictors of short-term mental and functional changes in older adults undergoing elective surgery under general anesthesia.
The authors studies the cognitive, affective, and functional status of 172 mentally healthy patients, age 55 and older, who were undergoing elective surgery under general anesthesia. Patients were interviewed before and after surgery; this report focuses on changes 1 month postoperatively. Authors compared the mental status and function of 190 nonsurgical patients of comparable age. ⋯ Linear regression predictors of affective, cognitive, and functional change at follow-up included demographics, baseline measures of mental status and function, surgery type, and intraoperative measures. Longer duration of anesthesia--but not type of surgery--predicted short-term decline in activities of daily living but not cognition or affect. Authors discuss results in the context of previous findings in which surgery had no impact on mental status or function at 10-month follow-up.
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Am J Geriatr Psychiatry · Jan 1998
Delusions and hallucinations in an adult day care population. A longitudinal study.
The frequency of the manifestation of delusions and hallucinations (d/h) among participants of adult day care centers was examined, as was the relationship of d/h to demographic and medical variables, agitation, depressed affect, and dementia. Changes in d/h were also assessed over a 1-year period, and those changes were compared with changes in agitation, depressed affect, and dementia. ⋯ Dementia was also related to d/h, although a substantial percentage of individuals who were not diagnosed with dementia also experienced some type of d/h. Finally, delusions were more prevalent and generally tended to relate more strongly to agitation, depressed affect, and dementia than did hallucinations.
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Am J Geriatr Psychiatry · Jan 1998
Measuring delirium severity in older general hospital inpatients without dementia. The Delirium Severity Scale.
The authors evaluated the validity, reliability, and sensitivity to change of the Delirium Severity Scale (DSS), a 10-minute assessment consisting of Forward Digit Span and Similarities. Twenty-two older inpatients with delirium but not dementia and 15 control patients were administered the DSS during hospitalization. ⋯ The DSS showed significant improvement over time (P < 0.001) and significant correlation with improvement in expert ratings (P = 0.026). The DSS shows promise as a valid and reliable measure sensitive to changing symptom severity.