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Elderly people often experience multiple comorbidities that may contribute to the phenomenon of sundowning syndrome through neurodegeneration. Neurological disorders: Alzheimer's disease, Parkinson's disease , Huntington's disease , Lewy body dementia , fronto-temporal dementia, subcortical dementia.
(Pneumonia, for example, may present with low-grade fever and confusion, rather than the high fever and cough seen in younger people.) Some elderly people may find it hard to describe their symptoms in words, especially if the disease is causing confusion, or if they have cognitive impairment .
Late-life depression is often underdiagnosed, which is due to numerous reasons, including that depressed mood is commonly not as prominent as other somatic and psychotic symptoms such as loss of appetite, disruptions in sleep, lack of energy or anergia, fatigue, and loss of interest and enjoyment in normal life activities.
More likely in the elderly with pre-existing declining mental functions, termed mild cognitive impairment (MCI). [13] MCI is a transitional zone between normal mental function and evident Alzheimer's disease or other forms of dementia. It is insidious, and seldom recognized, except in retrospect after affected persons are evidently demented.
Delirium (formerly acute confusional state, an ambiguous term that is now discouraged) [1] is a specific state of acute confusion attributable to the direct physiological consequence of a medical condition, effects of a psychoactive substance, or multiple causes, which usually develops over the course of hours to days.
Geriatric psychiatry is a subspecialty of psychiatry dealing with the research, diagnosis and treatment of mental disorders in the later stages of life. [1] [2] [3] The field composes of the diagnosis, treatment, and management of areas such as depression, dementia, and Alzheimer's disease. A geriatric psychiatrist is also a licensed doctor ...
Confusional arousals are accompanied by mental confusion and disorientation, relative lack of response to environmental stimuli, and difficulty of awakening the subject. [3] [4] [5] Vocalisation accompanied with coherent speech is common. [3] Patients may appear upset, and some of them become aggressive or agitated. [4]
In hospitals, the elderly face the very real problem of ageism. For example, doctors and nurses often mistake symptoms of delirium for normal elderly behavior. Delirium is a condition that has hyperactive and hypoactive stages. In the hypoactive stages, elderly patients can just seem like they are sleeping or irritable. [15]