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Geriatrics > Dementia, Depression, Delirium LO > Flashcards

Dementia, Depression, Delirium LO Flashcards

1
Q

factors that increase major depressive disorder (MDD) in the elderly

A
  • Being female
  • Being single, unmarried, divorced or widowed
  • Lack of a supportive social network
  • Stressful life events
  • Damage to body image: imputation, heart attack, cancer, etc.
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2
Q

classic presentation of MDD in the elderly

A
  • Vague complaints of pain
  • Deny depression
  • Minimize severity of symptoms
  • Hesitant to admit illness
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3
Q

incidence of MDD in nursing home patients

A

50%

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4
Q

the 5 questions of the geriatric depression scale to screen for MDD in older adults

A
  1. Are you basically satisfied with your life?
  2. Do you often get bored?
  3. Do you feel hopeless?
  4. Do you prefer to stay at home rather than going out and doing new things?
  5. Do you feel pretty worthless the way you are now?
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5
Q

Identify the common physical findings in an elderly patient with MDD

A

• Usually none
• If more severe symptoms: can see decline in grooming/hygiene
• Weight gain/loss
• Psychomotor retardation: slowing/loss of spontaneous movement/reactivity
• Flattening/loss of reactivity in patient’s affect
• Speech
- May be normal, slow, monotonic, or lacking in spontaneity and content
- Pressured speech should suggest mania
- Disorganized speech should suggest psychosis

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6
Q

risks associated with antipsychotic use in the elderly

A
  • Pneumonia
  • Life-threatening arrhythmias
  • Orthostatic hypotension resulting in falls
  • Diabetes
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7
Q

common symptoms of delirium in elderly patients

A
  • Hallmark: inability to pay attention → resulting confusion and disorientation
  • May be fluctuating level of consciousness
  • Symptoms can change even from minute to minute
  • May have visual hallucinations, paranoia or delusions
  • Personality and mood may change
  • Can cause coma or death
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8
Q

percent of hospitalized patients over the age of 70 who experience delirium

A

up to 56% of hospitalized patients

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9
Q

prognosis of elderly patients with delirium

A
  • Overall prognosis is dependent on etiology
  • Hospitalized patients who develop delirium are 10x more likely to have complications (including death) in the hospital
  • Patients admitted with delirium have mortality rates up to 26%
  • Elderly patients may take 8+ weeks to fully recover
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10
Q

reversible causes of dementia.

A
  • Drugs (any drug with cholinergic activity)
  • Emotional (depression)
  • Metabolic (hypothyroid)
  • Eyes/ears declining
  • Normal pressure hydrocephalus
  • Tumor/other space-occupying lesion
  • Infection (syphilis, AIDS)
  • Anemia (B12/folate deficiency)
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11
Q

irreversible causes of dementia

A
  • Alzheimer disease
  • Vascular dementia
  • Parkinson’s disease
  • Lewy Body disease
  • Huntington disease
  • Creutzfeldt-Jakob disease
  • Pick disease
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12
Q

Onset

  • delirium
  • dementia
  • depression
A
  • acute
  • insidious
  • often with rapid onset and IDable trigger
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13
Q

Course

  • delirium
  • dementia
  • depression
A
  • fluctuating
  • progressive
  • variable
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14
Q

Duration

  • delirium
  • dementia
  • depression
A
  • Days to weeks
  • months to years
  • variable
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15
Q

Consciousness

  • delirium
  • dementia
  • depression
A
  • Altered
  • normal
  • normal
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16
Q

Attention

  • delirium
  • dementia
  • depression
A
  • impaired
  • nl, except in severe cases
  • may be affected
17
Q

Psychomotor changes

  • delirium
  • dementia
  • depression
A
  • increased or decreased
  • often normal
  • sometimes slowing
18
Q

Reversibility

  • delirium
  • dementia
  • depression
A
  • usually
  • rarely
  • often, reoccurrence is possible
19
Q

Memory

  • delirium
  • dementia
  • depression
A
  • not affected
  • greatly affected
  • subjective complaint of memory
20
Q

Mental State

  • delirium
  • dementia
  • depression
A
  • emotional lability
  • possible emotional lability
  • distressed/unhappy
21
Q

Delusions/hallucinations

  • delirium
  • dementia
  • depression
A
  • Common
  • later stages
  • rare
22
Q

Answers to questions

  • delirium
  • dementia
  • depression
A
  • variable
  • near-miss answers
  • “don’t know” answers
23
Q

Performance

  • delirium
  • dementia
  • depression
A
  • ?
  • Tries hard but unconcerned about losses
  • does not try hard, is more distressed by losses

Geriatrics (14 decks)

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