Psychiatr. pro Praxi, 2005; 3: 148-150

Deliria na gerontopsychiatrickém oddělení

MUDr. Jiří Konrád
Psychogeriatrický primariát, Psychiatrická léčebna Havlíčkův Brod

Delirium je častou neuropsychiatrickou komplikací nemocí ve stáří (2, 7). Delirium velmi často komplikuje již přítomnou demenci. Sdělení se zabývá především těmito stavy – delirii nasedajícími na demenci. Ve zdravotnických a sociálních zařízeních pro osoby vysokého věku se delirium vyskytuje dle různých zdrojů v 10 až 44 % (6, 7, 13). Nemocní s chronickým kognitivním deficitem a trpící více chorobami bývají postiženi častěji (11). Je obtížné odlišit delirium od demence s příznaky BPSD (behaviorální a psychologické příznaky demence), zvláště když nemáme k dispozici kvalitní anamnézu a objektivní informace o nynějším onemocnění.

Autor uvádí obecné rozdíly umožňující diferenciální diagnostiku demencí a delirií (4), vlastní pozorování výskytu delirií na gerontopsychiatrickém oddělení psychiatrické léčebny, jejich příčiny a možnosti léčby a nakonec kazuistiku s užitím kognitiva – inhibitoru cholinesteráz (ICHE) – v léčbě deliria nasedajícího na demenci.

Published: February 1, 2006  Show citation

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Konrád J. Deliria na gerontopsychiatrickém oddělení. Psychiatr. praxi. 2005;9(3):148-150.
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    References

    1. Bonner LT, Peskind ER. Pharmacologic treatments of dementia. Med Clin North Am, 2002; 86(3): 657-74. Go to original source... Go to PubMed...
    2. Burns A, McKeith G. Old age psychiatry, B. J. Psychiat, Feb. 2002; 180: 97-98. Go to original source... Go to PubMed...
    3. Cummings JL, Back C. The cholinergic hypothesis of neuropsychiatric symptoms in Alzheimer's disease., Am J Geriatr Psychiatry, 1998; 6: 64-78. Go to original source... Go to PubMed...
    4. Eikelenboom P, Hoogendijk WJG. Do delirium and Alzheimer's dementia share specific pathogenetic mechanisms?, Dementia; 1999; 10: 319-324. Go to original source... Go to PubMed...
    5. Gustafson Z, Lundstrom M, Bucht G, Edmund A. Delirium in old age can be prevented and treated, Tidsskr Nor Laegeforen, 2002, Mar 20; 122 (8): 810-814. Go to PubMed...
    6. Levkoff SE, Evans DA, Liptzin B, et al. Delirium. The occurrence and persistence of symptoms among elderly hospitalized patients, Arch Intern Med., 1992; 152: 334-340. Go to original source...
    7. Lipowski ZJ. Delirium: Acute Confusional States. New York, Oxford University Press, 1990.
    8. McKeith IG, Galasko D, Kosaka K, et al. Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB). Report of the consortium on DLB international workshop. Neurology, 1996; 47: 1113-1124. Go to original source... Go to PubMed...
    9. Moretti R, Torre P, Antonello RM, Cattaruzza T, Cazzato G. Cholinesterase inhibition as a possible therapy for delirium in vascular dementia: a controlled, open 24-month study of 246 patients. Am J Alzheimers Dis Other Demen, 2004; 19(6): 333-339. Go to original source... Go to PubMed...
    10. Mosimann UP, McKeith IG. Dementia with lewy bodies-diagnosis and treatment. Swiss Med Wkly, 2003; 133(9-10): 131-142. Go to PubMed...
    11. O'Keeffe S, Lavan J. The prognostic significance of delirium in older hospital patients, J Am Geriatr Soc., 1997; 45: 174-178. Go to original source... Go to PubMed...
    12. Perry EK, Perry RH. Acetylcholine and hallucinations: disease-related compared to drug-induced alterations in human consciousness, Brain kogn, 1995; 28: 240-258. Go to original source... Go to PubMed...
    13. Sandberg O, Gustafson Y, Brannstrom B, Bucht G. Prevalence of dementia, delirium and psychiatric symptoms in various care settings for the elderly, Scand J Soc Med., 1998; 26: 56-62. Go to original source... Go to PubMed...
    14. Sarter M, Bruno JP. Cortical acetylcholine, reality distortion, schizophrenia, and Lewy body dementia: too much or too little cortical acetylcholine? Brain kogn, 1998; 38: 297-316. Go to original source... Go to PubMed...
    15. Wengel SP, Roccaforte WH, Burke WJ. Donepezil improves symptoms of delirium in dementia: implications for future research. J Geriatr Psychiatry Neurol, 1999; 11(3): 159-161. Go to original source... Go to PubMed...

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