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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

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Published on: September 30, 2020

Delirio en personas mayores.

Sharon K Inouye¹, Rudi G J Westendorp², Jane S Saczynski³

¹Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA.

Lancet (London, England)

|September 3, 2013

Resumen

El delirio, un trastorno cognitivo agudo común y grave en adultos mayores, requiere un diagnóstico formal. La prevención no farmacológica es la más efectiva, ya que los tratamientos farmacológicos carecen de evidencia.

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Área de la Ciencia:

Geriatría La geriatría es la especialidad de la geriatría.
Neurología Neurología.
Salud Pública La salud pública.

Sus antecedentes:

El delirio es un trastorno agudo frecuente, grave y a menudo fatal que afecta la atención y la cognición en personas de 65 años o más.
Es poco reconocido a pesar de los costos significativos y la mortalidad.
El diagnóstico se basa en la evaluación cognitiva formal y una historia de aparición de síntomas agudos.

Objetivo del estudio:

Revisar la comprensión actual del delirio en los ancianos.
Para resaltar estrategias efectivas de prevención y tratamiento.
Para enfatizar el papel del delirio en la comprensión de la fisiopatología del cerebro y la seguridad del paciente.

Principales métodos:

Revisión de la literatura existente sobre el diagnóstico, la prevención y el tratamiento del delirio.
Análisis de las implicaciones del delirio para la salud cerebral y la seguridad del paciente.
Discusión de las prioridades de salud pública relacionadas con el delirio.

Principales resultados:

Los enfoques multicomponentes y no farmacológicos son la estrategia más efectiva para la prevención del delirio.
No hay evidencia convincente que respalde la eficacia de la prevención o el tratamiento farmacológico.
Se recomienda la reducción de fármacos para sedación y analgesia, junto con métodos no farmacológicos.

Conclusiones:

El delirio sirve como un marcador de vulnerabilidad cerebral y un mecanismo potencial para el daño cognitivo.
Abordar el delirio es crucial para mejorar la seguridad del paciente e impulsar mejoras en los procesos de todo el sistema.
Los esfuerzos de salud pública deben centrarse en la mejora de la codificación, el reembolso, la financiación de la investigación y la educación para los médicos y el público.