Zeitschrift für Gerontologie und Geriatrie
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Observational Study
Aspects and assessment of delirium in old age. First data from a German interdisciplinary emergency department.
The prevalence of delirium in hospitalized patients is high, but delirium is frequently not identified by treating physicians in emergency departments (EDs). Although the number of elderly patients admitted to EDs is increasing, no data on prevalence, identification and outcome of delirious elderly patients in German EDs exist. ⋯ Elderly patients with known risk factors should be routinely assessed for delirium in the ED with a standardized assessment tool such as the CAM.
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Sound knowledge in the care and management of geriatric patients is essential for doctors in almost all medical subspecialties. Therefore, it is important that pregraduate medical education adequately covers the field of geriatric medicine. However, in most medical faculties in Europe today, learning objectives in geriatric medicine are often substandard or not even explicitly addressed. ⋯ In order to ease the implementation of this new, competence-based curriculum among the medical faculties in universities teaching in the German language, the authors translated the published English language curriculum into German and adapted it according to medical language and terms used at German-speaking medical faculties and universities of Austria, Germany and Switzerland. This article contains the final German translation of the curriculum. The Geriatric Medicine Societies of Germany, Austria, and Switzerland formally endorse the present curriculum and recommend that medical faculties adapt their curricula for undergraduate teaching based on this catalogue.
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In geriatric patients with Pauwels II and III type femoral neck fractures, endoprosthesis is the treatment of choice. ⋯ Endoprosthesis placement for displaced femoral neck fractures is a common, safe procedure. However, the patients are old and have comorbidities. Despite recent decreases in hospital mortality, the risk of death remains more than twice as high within 1 year than that for uninjured patients of the same age.
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Current research on autobiographical memory distinguishes between a self function, a directive function, and a social function of autobiographical memory. From a lifespan perspective, the use of autobiographical memory for these functions is expected to decrease with age. The present study extended these functions by the function of nostalgia: Often triggered by negative emotions, remembering personal and positive experiences might, among others, enhance positive effects. This emotion-regulating function is expected to become more important in old age. ⋯ Exploratory and confirmatory factor analyses supported a four-factor model reflecting the presumed self, directive, social, and nostalgia functions of autobiographical memory. The results showed a decrease in the use of autobiographical memory for self, directive and social functions with increasing age, whereas the nostalgia function followed a U-shaped pattern.
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Delirium, the acute deterioration of cognitive function and attention, is the most frequent mental disorder in elderly. Its correct diagnosis and adequate management are of crucial importance for the patient's health and functional outcome. ⋯ Causal therapy (i.e., treatment of the causal condition and/or eliminating the precipitating situation) is imperative. It must be accompanied by nursing and environmental measures and, if necessary, by antipsychotic and/or sedating symptomatic treatment.