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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.
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.
Treatment depends on the degree of decrease in consciousness and its underlying cause. Initial treatment often involves the administration of dextrose if the blood sugar is low as well as the administration of oxygen, naloxone and thiamine. [citation needed]
The most promising therapeutic effect is achieved when the treatment continues for at least six weeks. [36] Underuse or misuse of antidepressants and prescribing inadequate dosages are the most common mistakes physicians make when treating elderly patients for depression. Only 10% to 40% of depressed elderly patients are given medication.
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.
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]
Improved reaction times were noted at 52 weeks in elderly patients free from benzodiazepines. This is an important function in the elderly, especially if they drive a car due to the increased risk of road traffic accidents in benzodiazepine users. [136] At the 24-week follow-up, 80% of people had successfully withdrawn from benzodiazepines.
The subspecialty of Geriatric neurology is defined by its expertise in the diagnosis, treatment, and care of neurological conditions that affect elderly and by its unique body of knowledge regarding the aging nervous system, its vulnerability to specific neurological disorders, and its influence on the prevalence and expression of neurological ...