European journal of internal medicine
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Eur. J. Intern. Med. · Sep 2012
Review Historical ArticleDelirium: its historical evolution and current interpretation.
Delirium was one of the first mental disorders ever to be described, though it remains an elusive concept to this day. Historically, delirium has developed from the prototype of acute confusion with psychomotor agitation. ⋯ Four core features defines delirium at present: a disturbance of consciousness, a disturbance of cognition, limited course and external causation. However, these features do not include common manifestations of delirium in elderly patients with dementia; therefore the concept of delirium should be revised and corrected.
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Eur. J. Intern. Med. · Sep 2012
ReviewPreoperative geriatric assessment: comprehensive, multidisciplinary and proactive.
With the changing global demographic pattern, our health care systems increasingly have to deal with a greater number of elderly patients, which consequently also takes its toll on our surgical services. The elderly are not simply older adults. ⋯ In order to ensure a safe perioperative period, we believe that a comprehensive, multidisciplinary and proactive preoperative assessment will be helpful to detect the multiple risk factors and comorbidities common in older patients, to assess functional status and simultaneously allow room for early preoperative interventions and planning of the intra- and postoperative period. In this review we outline the currently available preoperative geriatric risk assessment tools and provide an insight on how a comprehensive, multidisciplinary and proactive approach can help improve perioperative outcome.