Articles: dementia.
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Using an actigraph, the activity patterns in 13 demented patients with delirium were examined. We analyzed the data of the eight patients, wearing the actigraphs for more than 10 days. They were classified into four types: type A, nocturnal delirium type; type B, wandering type; type C, hypobulia type; and type D, lying down type. ⋯ The dominant period of activity rhythm was nearly 24 h in all cases. Additional 12-h period was observed in type C. Actigraphs might become useful in making therapeutic decisions regarding demented patients with delirium.
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Confusion in the elderly patient is usually a symptom of delirium or dementia, but it may also occur in major depression and psychoses. Until another cause is identified, the confused patient should be assumed to have delirium, which is often reversible with treatment of the underlying disorder. ⋯ Major irreversible causes include Alzheimer's disease, central nervous system damage and human immunodeficiency virus infection. All but the rarest causes of confusion can usually be identified based on the complete history, medication review, physical examination, mental status evaluation and laboratory evaluation with longitudinal reevaluation.
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Dtsch. Med. Wochenschr. · Mar 1998
Review Case Reports[Autoimmune encephalopathy in Hashimoto's thyroiditis. A differential diagnosis in progressive dementia syndrome].
A 58-year-old woman, known for 10 years to have Hashimoto's thyroiditis, was admitted from another hospital where, after an initial period of unconsciousness, she had developed progressive severe dementia, abnormal arousal and generalized myoclonia. Jakob-Creutzfeldt disease (JCD) was suspected. ⋯ In case of rapidly progressive dementia autoimmune antibodies should be looked for in the differential diagnosis, because autoimmune disease may be the treatable cause.
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The elderly population in the United States is increasing gradually. Estimates project that during the next 50 years 21% of the population, or approximately 70 million people, will be older than 65 years. Various medical and psychiatric disorders produce cognitive disturbances that result in temporary or permanent incompetence. ⋯ Problems exist related to obtaining informed consent from the elderly and distinguishing between incapacitated versus incompetent individuals. Physicians are responsible for providing information to their patients about a durable power of attorney for health care, a living will, and "do not resuscitate" orders, before they lose their capacity to make decisions related to their health care. Informed consent, living wills, durable power of attorney for health care, and guardianship are discussed.