Two cases of steroid dementia showing partial recovery during 2‐year follow‐up

Abstract

Background: Steroid dementia has been reported since the 1970s. In the current superaged society, it increasingly receives attention because of the growing number of elderly people that are medicated with steroids for systemic rheumatic disease. Case Presentation: We report two cases of steroid dementia that were diagnosed as a result of careful observation of clinical symptoms and biological examination, including nuclear medicine tests. Cognitive and daily living functions were partially recovered in both cases after decrease or discontinuance of steroid medication in 2-year follow-up, but their daily living function could not be totally restored to premorbid level. Conclusion: Cognitive dysfunction caused by steroids is suggested by these cases, although definitive diagnosis in these cases is not possible. It was partially reversible over the course of a few years, but some functional loss remains. Cognitive function should be assessed appropriately before, during, and after steroid treatment. Detailed differential diagnosis of neurodegenerative disorders and longitudinal follow-up is required when cognitive dysfunction is observed after initiation of steroid therapy.

Management of Scleritis in Older Adults

“…A further consideration in the use of corticosteroids, both IVMP and oral prednisone, in the elderly patient is the potential risk of delirium. Fortunately, this side effect is less common although does appear to be more frequent at higher doses (>40 mg of prednisone daily) and is likely to present within the first 1–2 weeks of treatment [ 68 , 69 ]. Older age (>60 years) has also been shown to be an independent risk factor for transition to delirium following treatment with systemic corticosteroids, though these were high-dose corticosteroids in patients who were already hospitalized [ 70 ].…”