Physicians' assessment of cognitive capacity. Failure to meet the needs of the elderly

McCartney, John

doi:10.1001/archinte.146.1.177

Cited by 18 publications

(13 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Failure to recognize delirium or misdiagnosis of delirium is common [13,50,59,68,69,77]. Bruera et al reported that in patients admitted to a palliative care unit, routine conversation without an objective assessment of cognition resulted in the diagnosis of cognitive impairment being missed by physicians and nurses in 23% and 20% of cases, respectively [13].…”

Section: Issues In the Recognition Of Deliriummentioning

confidence: 99%

Delirium and dehydration: some fluid for thought?

Lawlor

2002

Support Care Cancer

View full text Add to dashboard Cite

Delirium is a frequent complication of advanced cancer. It is characterized by cognitive deficits and behavioral disturbance, and therefore can potentially result in severe symptom distress and impeded communication between patient and family and between patient and medical staff. The reversibility of delirium depends on its underlying causes. Delirium is multifactorial in origin, and precipitating or contributory factors include dehydration and hypovolemia. Much of the debate concerning the role of hydration in advanced cancer has centered on symptoms such as thirst, and ethical issues such as parenteral hydration and its association with prolongation of life, with the association between hydration status and delirium largely excluded. This review examines the latter association in the light of recent studies. It also provides an outline of relevant pathophysiology and clinical assessment, a decision-making framework and a practical approach to the techniques of assisting hydration. This will hopefully help physicians and families in weighing up the merits of assisted hydration in an individual context and help them to achieve a consensus on the role of hydration that is consistent with the goals of care.

show abstract

Section: Issues In the Recognition Of Deliriummentioning

confidence: 99%

Delirium and dehydration: some fluid for thought?

Lawlor

2002

Support Care Cancer

View full text Add to dashboard Cite

show abstract

“…Moreover, physicians fail to recognize a high proportion of patients with cognitive defects under their care (McCartney, 1986). There is no reason to believe that surgeons are any more competent in this respect.…”

Section: Diagnosismentioning

confidence: 99%

Postoperative confusion in the elderly

Whitaker¹

1989

Int J Geriat Psychiatry

View full text Add to dashboard Cite

SUMMARYWith advancing age, postoperative confusion is an increasingly important problem. Its aetiology is complex and multifactorial and includes surgical factors, anaesthetic factors, preexisting medical, psychiatric or psychological problems and postoperative complications. It often prolongs hospital stay and although mental function recovers in the majority of cases, it may be followed by permanent mental impairment. Postoperative confusion may interfere with the management of the original surgical problem and it occurs in a setting where interest and expertise in its management are low. There is scope for improved recognition, treatment and prevention of postoperative confusion. More work needs to be done to evaluate the effect of surgery and anaesthesia on mental function, especially in the very e I d e r 1 y .

show abstract

“…"False negatives" in which the presence of dementia is missed, remain common, primarily due to failure to appreciate dementia in the setting of psychiatric illness. 98 Up to 80% of the normal elderly will note some deterioration in memory over time and sometimes complain of this. 99 Patients with depression but no dementia may complain of subjective memory loss quite strongly, although no objective evidence of memory difficulties is found on formal testing.…”

Section: Historymentioning

confidence: 99%

“…98 The MSE is time consuming and in practice often relies on a limited battery of memory and cognitive tests or else screening tools such as the MMSE. 112 Even simple screening tests can be highly useful in that they can support the objective presence of memory impairment.…”

Section: Mental Status Testing and Neuropsychological Screeningmentioning

confidence: 99%

Assessment of Suspected Dementia

Chertkow

Bergman

Schipper

et al. 2001

Can. J. Neurol. Sci.

View full text Add to dashboard Cite

At the Second Canadian Consensus Conference on Dementia (CCCD) (February, 1998), a group of neurologists, geriatricians, and psychiatrists met to consider guidelines for evaluation of dementia in Canada. This review paper formed a background paper for their discussion of dementia diagnosis. These experts from across the country concluded that diagnosis of suspected dementia cases continued to rest on skilled clinical assessment. Mental status exam, preferably in some quantifiable form, has become an essential part of the assessment. Selected laboratory tests are advisable in all cases (CBC, TSH, electrolytes, calcium, and glucose), but the CCCD continued to advise that CT scanning was mandatory only in selected cases where clinical findings pointed to another possibility besides Alzheimer’s disease. The growing list of other diagnostic measures with potential usefulness in diagnosis of Alzheimer’s disease or dementia in general was reviewed, but the evidence was judged as insufficient to support routine use of these tests by physicians. As new treatments for Alzheimer’s disease become available, neurologists face new diagnostic challenges - differentiating Mild Cognitive Impairment, Frontotemporal dementias and Mixed dementias, and Lewy Body Dementia. Guidelines to aid in differential diagnosis are presented.

show abstract

Physicians' assessment of cognitive capacity. Failure to meet the needs of the elderly

Cited by 18 publications

References 0 publications

Delirium and dehydration: some fluid for thought?

Delirium and dehydration: some fluid for thought?

Postoperative confusion in the elderly

Assessment of Suspected Dementia

Contact Info

Product

Resources

About