[Review in geriatric medicine 2014]

Area of Science:

• Geriatrics and Gerontology
• Neurology
• Pharmacology

Context:

• Advances in the diagnostic and prognostic assessment of delirium in hospitalized older patients.
• Growing understanding of interventions for benzodiazepine withdrawal and dementia care.
• Emerging evidence on pharmacological and non-pharmacological approaches for Alzheimer's dementia.

Purpose:

• To synthesize recent findings relevant to the care of older adults, focusing on delirium, dementia, and related conditions.
• To evaluate the efficacy of various interventions, including patient education, nutritional support, and novel therapeutics.
• To provide an overview of current evidence for preventative strategies and treatment options for Alzheimer's dementia.

Summary:

• Direct patient education is effective for benzodiazepine withdrawal.
• Tube feeding is not recommended for advanced dementia with eating difficulties.
• Preventative interventions like physical activity may delay dementia.
• Monoclonal antibodies targeting amyloid showed no benefit in mild-to-moderate Alzheimer's dementia (AD).
• Vitamin E reduced functional decline, and citalopram reduced agitation in AD patients.

Impact:

• Improved diagnostic and prognostic capabilities for delirium in older patients.
• Evidence-based recommendations for managing eating difficulties in advanced dementia.
• Reinforced importance of lifestyle interventions for dementia prevention.
• Clarified therapeutic landscape for Alzheimer's dementia, highlighting both limitations of amyloid-targeting antibodies and potential benefits of vitamin E and citalopram.