Geriatric Psych Flashcards
drug induced dementia
diphenhydramine
what is most important in the evaluation of dementia in elderly
history and physical
what labs should be ordered when evaluating for dementia
- endocrine
- B12
- folate
- CBC
- CMP
- HbA1C
what agents attempt to slow progression of dementia and increase patient functionality
- Donepezil: actetylcholinesterase inhibitor
- Memantine: NMDA antagonist
AVOID ANTICHOLINERGIC MEDS WHICH CAN IMPAIR COGNITIVE FUNCTION ESPECIALLY IN ELDERLY . . which ones?
- Benadryl
- Hydroxyzine
Black Box Warning in treating dementia in elderly
increases mortality when given antipsychotics like olanzapine, aripiprazole, risperidone, or quetiapine
what are the risk factors for substance abuse in elderly
- Female
- Marital status: single, separated, or divorced and living alone
- Absence of hobbies and socialization
- Health concerns
Informing your patients about substance abuse gives them knowledge which gives them control and will increase what
compliance
primary causes of depression in the elderly
- Deteriorating health
- Cognitive Decline
- Loss of independence
- Loss of spouse and friends
What is the criteria for major depression in elderly
- Anhedonia or depressed mood for 2 weeks AND 4 of following:
- feelings of worthlessness or guilt
- decreased ability to concentrate
- Fatigue
- Psychomotor agitation
- Insomnia or hypersomnolence
- Weight or appetite changes
- Recurrent thought of suicide or death
Geriatric depression scale score interpretations
- > 5 is suggestive of depression
- > 10 is almost always indicative of depression
- > 5 should warrant a follow up comprehensive assessment
How do you differentiate b/t Dementia and Depression in elderly population
- Use a mental status exam and focus on your patient’s “insight”
- Depressed patients WILL often have insight, though little effort
- Dementia patients: little/NO insight
