Ageing deck 1 Flashcards
What common problem can cause confusion in the elderly?
Dehydration
What is the definition of delirium?
Acute confusional state
What are the four most common signs/symptoms of delirium?
Disturbance in attention
Change in cognition
Develops over a short period
Tends to fluctuate
What are some pathophysiology theories that try to explain the causes of delirium? (3)
Variable derangement of multiple neurotransmitters (particularly ACh)
Direct toxic insults to the brain
Aberrant stress response
What are the most common causes of delirium?
Hip fracture
UTI
Polypharmacy
Is delirium associated with dementia?
YES
Higher risk of getting dementia if you have a history of delirium
What is the onset of delirium?
Sudden (hours/days)
Is delirium reversible?
Oui
How long does delirium last?
No more than a few months
What does the 4AT measure?
Alertness
AMT4 (age, DoB, place, current year)
Attention (months of yr backwards)
Acute change/fluctuating course
What does CAM measure?
Acute and fluctuating course
+
Inattention
with either
Disorganised thinking
and/or
altered level of consciousness
What are the 2 delirium subtypes?
Hyperactive
Hypoactive
What are the signs/symptoms in a patient with HYPERactive delirium?
Agitated
Aggressive
Wandering
What are the signs/symptoms of a patient with HYPOactive delirium?
Withdrawn
Apathetic
Sleepy
Coma
Does delirium have a singular cause?
Non!
Often multiple causes
What are some key investigations to do in a patient presenting with delirium?
Find cause!
- Bloods
- Review meds
- Check hydration
- Stop nephrotoxic drugs
- BP/perfusion
What are some environmental/supportive factors to consider for a patient with delirium?
- Calm environment
- Sleep chart
- Family brings things from home
- Glasses and hearing aids (if necessary)
etc
When should you sedate a patient with delirium?
Only if they are a danger to themselves or staff
What are some pharmacological measures that can be used in patients with delirium?
Haloperidol
Quetiapine (Parkinson’s/Lewy body dementia)
Benzodiazepines
When can you use benzodiazepines in a patient with delirium?
If alcohol/benzodiazepine withdrawal or seizure
Lorazepam
Can worsen delirium
What is sarcopenia?
Age related loss of muscle mass and function
What is the classification system for sarcopenia?
Must have 1 plus 2 or 3
- Low muscle mass
- Low muscle strength
- Low physical performance
At what age does muscle mass begin to decline?
Age 30
What is sarcopenic obesity?
Low muscle mass + increased fat levels
What is main way to prevent sarcopenia?
EXERCISE
What is cachexia?
Weakness and wasting of the body due to severe chronic illnesses
What is the recommended amount of exercise for an elderly person?
Same as for an adult
150 mins per week
What are 2 drugs you could consider giving to a patient with sarcopenia?
ACEi
Creatine
Why would you consider giving an ACEi to a person with sarcopenia?
Reduces inflammation and improves mitochondrial function
Why would you consider supplementing creatine in a person with sarcopenia?
Dietary compound that is involved in delivering energy to muscles
