International journal of geriatric psychiatry
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Int J Geriatr Psychiatry · Jul 2005
ReviewClinical subtypes of delirium and their relevance for daily clinical practice: a systematic review.
Delirium is a disorder that besides four essential features consists of different combinations of symptoms. We reviewed the clinical classification of clusters of symptoms in two or three delirium subtypes. The possible implications of this subtype classification may be several. The investigation and exploration of clinical subtypes of delirium may provide information concerning the etiology, the pathogenesis, and the prognosis of delirium, but also may have therapeutic consequences. ⋯ We conducted a systematic review and retrieved ten clinical studies. The studies described in this review show different results, partly due to methodological problems and possibly by lack of a standard classification for delirium subtypes. According to the present literature a useful and reproducible method to classify (patterns of) symptoms in delirium subtypes seems to be the general rating of and division in to psychomotor subtypes. The Memorial Delirium Assessment Scale (MDAS) and the Dublin Delirium Assessment Scale (DAS) appear to be reliable methods, together with the new version of the Delirium Rating Scale (DRS-R-98).
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Int J Geriatr Psychiatry · Jul 2005
ReviewDon't seize the day hospital! Recent research on the effectiveness of day hospitals for older people with mental health problems.
Day hospital (DH) care remains a core component of mental health services for older people. However, there has been an ongoing debate about the effectiveness and value for money of DHs in comparison to day centres (DC). ⋯ Recent research supports the effectiveness of day hospitals, but further studies are needed in order to provide a more robust evidence base.
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In the United Kingdom there are some key facts which have implications for policies and services for people with dementia. The first group are to do with older people and their position in the total population. Overall the population of this country is projected to increase, but only by 0.2%. ⋯ Both of these will have an effect on who is available to care. But we also need to look at the implications of population change in the EU which have implications for the UK. Some of the implications and issues of these population aspects are then discussed.
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Int J Geriatr Psychiatry · Jan 2000
ReviewDementia in developing countries. A consensus statement from the 10/66 Dementia Research Group.
Less than one-tenth of all population-based research into dementia is directed towards the two-thirds or more of cases living in developing parts of the world. The 10/66 Dementia Research Group has been formed to redress this imbalance, encouraging active research collaboration between centres in different developing countries and between developed and developing countries. The 10/66 group consisted initially of researchers attending a symposium on dementia research in developing countries, held at the 1998 Alzheimer's Disease International conference. ⋯ There was felt to be an urgent need for more research: quantifying prevalence and incidence, exploring regional variations in international collaborations using harmonized methodologies, describing care arrangements for people with dementia, quantifying the impact on caregivers and evaluating the effectiveness of any newly implemented services. Methodological problems need to be addressed, particularly development of culture- and education-fair dementia diagnostic procedures. Good-quality research can generate awareness, pioneer service development and influence policy.