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David Córcoles1, Angeles Malagón2, Magdalena Bellsolà2

  • 1Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, España.

Atencion Primaria
|June 18, 2017
PubMed
Summary

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Neuropsychiatric symptoms in older adults can mimic or mask cognitive impairment. Delusions and agitation are key symptoms that may confuse diagnosis in primary care settings.

Area of Science:

  • Geriatric Psychiatry
  • Cognitive Neurology
  • Primary Care Medicine

Background:

  • Cognitive impairment is a significant concern in the elderly population.
  • Neuropsychiatric symptoms can complicate the accurate assessment of cognitive function.
  • Primary care settings often serve as the initial point of contact for elderly patients.

Purpose of the Study:

  • To determine if neuropsychiatric symptoms interfere with detecting cognitive impairment in primary care.
  • To identify specific neuropsychiatric symptoms that cause diagnostic confusion.
  • To improve the diagnostic accuracy of cognitive impairment in elderly patients presenting with psychiatric symptoms.

Main Methods:

  • A descriptive, observational study involving 104 elderly patients referred from primary care.
Keywords:
Atención primariaDemenciaDementiaHabilidad diagnósticaNeuropsychiatric symptomsPrimary careRecognitionSíntomas neuropsiquiátricos

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  • Utilized the Mini Mental State Examination (MMSE) and other psychiatric assessment tools.
  • Patients were evaluated by a mobile psychiatric unit collaborating with primary healthcare centers.
  • Main Results:

    • Over half (55.8%) of referred patients showed an altered MMSE score.
    • Delusions, hallucinations, agitation, disinhibition, irritability, and purposeless motor behavior were commonly associated with suspected cognitive impairment.
    • These symptoms frequently led to confusion in the diagnostic process.

    Conclusions:

    • The presence of new-onset severe mental disorder (SMD) symptoms in the elderly warrants suspicion of cognitive impairment.
    • Screening for cognitive impairment should be conducted when such psychiatric symptoms are observed.
    • Early detection and differentiation are crucial for appropriate management of cognitive decline in older adults.