Flashcards in Geriatric Psychiatry (Hill) Deck (12)
Geriatric pts under-report what?
Purpose of tx?
Elderly pts often fail to recognize and/or fail to report s/s of "aging"
Emphasis on palliative care instead of "living longer"
Meds-always start low and go slow
Various symptoms of dementia?
Depression --> pseudodementia
difficulty w/performing tasks, organization, coordination
problems with disorientation (get lost)
inappropriate behavior (esp Frontotemporal dementia)
Most important component for evaluating dementia in elderly?
H and P most important --> onset, character (type/manner of cognitive deficits)
Avoid Rx what in elderly with dementia?
Avoid anticholinergic meds which can impair cognitive function, ESP IN ELDERLY (Benadryl, hydroxyzine)
Black box warning with Olanzapine (zyprexa), aripiprazole (abilify), risperidone (risperdal), or quetiapine (seroqeul) for elderly with dementia?
Antipsychotic meds associated with increased mortality
-1.6-1.7-fold increase in mortality
-Most either d/t heart-related events (heart failure, sudden death) or Infx (mostly pneumonia)
This is the 3rd most common cause of psychosis in elderly outpatients
This condition accounts for most psychoses in elderly
Psychosis d/t Major Depressive Disorder w/ Psychotic features--> 2nd most common dx in elderly outpatients
This is most common dx accounting for psychosis in elderly outpatients
Psychosis d/t Alzheimers type dementia
often of a paranoid nature --> thinks items being stolen from them, being abandoned, spouse cheating
Can't go cold turkey with intense and chronic etoh abuse d/t ?
possible DT's and death
Med example: Benzo's (i.e., valium/Diazepam taper)
Major depression criteria for dx depression in elderly?
Anhedonia or Depressed mood for 2 weeks and 4 or more of:
-Feelings of worthlessness/guilt
-Decreased ability to concentrate
-Insomnia or hypersomnolence
-weight or appetite changes
-recurrent thoughts of suicide/death
How do you differentiate between DEMENTIA and DEPRESION in elderly?
Mental status exam--> focus on INSIGHT
Depressed --> WILL often have INSIGHT, though little effort
Dementia --> LITTLE/NO INSIGHT