Geriatric Psych Flashcards
(12 cards)
drug induced dementia
diphenhydramine
what is most important in the evaluation of dementia in elderly
history and physical
what labs should be ordered when evaluating for dementia
- endocrine
- B12
- folate
- CBC
- CMP
- HbA1C
what agents attempt to slow progression of dementia and increase patient functionality
- Donepezil: actetylcholinesterase inhibitor
- Memantine: NMDA antagonist
AVOID ANTICHOLINERGIC MEDS WHICH CAN IMPAIR COGNITIVE FUNCTION ESPECIALLY IN ELDERLY . . which ones?
- Benadryl
- Hydroxyzine
Black Box Warning in treating dementia in elderly
increases mortality when given antipsychotics like olanzapine, aripiprazole, risperidone, or quetiapine
what are the risk factors for substance abuse in elderly
- Female
- Marital status: single, separated, or divorced and living alone
- Absence of hobbies and socialization
- Health concerns
Informing your patients about substance abuse gives them knowledge which gives them control and will increase what
compliance
primary causes of depression in the elderly
- Deteriorating health
- Cognitive Decline
- Loss of independence
- Loss of spouse and friends
What is the criteria for major depression in elderly
- Anhedonia or depressed mood for 2 weeks AND 4 of following:
- feelings of worthlessness or guilt
- decreased ability to concentrate
- Fatigue
- Psychomotor agitation
- Insomnia or hypersomnolence
- Weight or appetite changes
- Recurrent thought of suicide or death
Geriatric depression scale score interpretations
- > 5 is suggestive of depression
- > 10 is almost always indicative of depression
- > 5 should warrant a follow up comprehensive assessment
How do you differentiate b/t Dementia and Depression in elderly population
- Use a mental status exam and focus on your patient’s “insight”
- Depressed patients WILL often have insight, though little effort
- Dementia patients: little/NO insight
