入院高齢者における妄想の危険因子

J D Schor¹, S E Levkoff, L A Lipsitz

¹Hebrew Rehabilitation Center for Aged, Boston, Mass.

JAMA

|February 12, 1992

まとめ

以前の認知障害,高齢化,骨折は,高齢の入院患者における妄想症の主要な危険因子です. 感染症や特定の薬剤などの病院内の要因も,この状態に寄与します.

科学分野:

ゲリアトリック・メディシン (老年医学)
病院病院医療病院医療
神経科学は神経科学である.

背景:

妄想症は,高齢の入院患者における一般的で深刻な症状です.
リスク要因を特定することは,予防と管理に極めて重要です.

研究の目的:

急性ケア病院に入院した高齢者のデリリウム発症に伴う危険因子を特定する.

主な方法:

展望的なコホート分析研究が行われました.
高齢者患者 (≥65歳) は,第三次医療病院に入院した.
潜在的な危険因子に関するデータは,医療記録から収集されました.

主要な成果:

291人の患者のうち91人に妄想を発症した.
独立した危険因子には,以前の認知障害 (OR,8.97),80歳以上の年齢 (OR,5.22),入院時の骨折 (OR,6.57),感染 (OR,2.96),および男性性別 (OR,2.40) が含まれていた.
神経麻痺薬 (OR,4.48) と麻薬使用 (OR,2.54) は妄想と関連していたが,抗コレリン薬の使用は関連していなかった.

結論:

入院高齢患者の妄想は,認知障害,高齢化,骨折などの入院前の要因と強く関連しています.
感染症や神経麻酔薬や麻薬の使用などの病院内の要因も妄想と関連しています.

さらに関連する動画

06:52

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

Published on: September 30, 2020

04:00

Identifying Frailty Using Point-of-Care Ultrasonography: Image Acquisition and Assessment

Published on: July 26, 2024

関連する概念動画

01:15

Drug Dosing: Geriatric Patients

Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...

01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are not...

01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

01:24

Drug Toxicity: Risk factors

Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...

01:30

Development of Human Microbiota

The human microbiota begins developing at birth and undergoes continual change as we age. Infancy marks a critical period of microbial sensitivity, offering a “window of opportunity” during which beneficial microbes help mature the immune system. By age three, children typically develop a more stable and diverse microbial community. Newborns acquire microbes from their immediate environment; vaginal delivery favors maternal vaginal microbes, while cesarean births favor microbes from the skin...

01:29

Alzheimer Disease l: Introduction

Alzheimer disease is a chronic, progressive, and irreversible neurodegenerative disorder and the most common cause of dementia in older adults. It leads to gradual neuronal loss, causing cognitive decline, behavioral changes, and loss of functional independence.Risk Factors and EtiologyThe disease is multifactorial. Age is the strongest risk factor, with prevalence doubling every 5 years after age 65. Genetic factors include mutations in genes such as APP, PSEN1, and PSEN2, which are associated...

関連する実験動画