Abstract
The normal ageing process affecting the brain reduces its capacity and its reserves, thereby making it vulnerable to both internal and external insults. The major manifestation of these insults, either single or usually multiple, is delirium. Delirium significantly increases both morbidity and mortality and is a life-threatening condition. The chapter provides an overview of delirium in the very elderly. The pathophysiology of delirium remains poorly understood. The chapter reviews briefly what is known of the pathophysiology. Several theories have been proposed to explain the initial and subsequent development of delirium. The final common outcome from the many factors or mechanisms seems to be associated with alteration in the neurotransmitter synthesis and function that mediates cognitive and behavioural changes.
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Multiple Choice Questions
Multiple Choice Questions
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1.
The following are true of delirium, EXCEPT:
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A.
In delirium the attention is reduced.
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B.
The hypoactive form occurs infrequently and often mistaken for depression or dementia.
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C.
The clinical manifestations can vary according to the precipitating cause.
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D.
Acute delirium is a common complication of medical illnesses.
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A.
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2.
The following are true of delirium, EXCEPT:
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A.
The term subsyndromal has been used to describe an intermediate stage between delirium and normal cognition.
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B.
Delirium can occur in pre-existing dementia and has been referred to as delirium superimposed on dementia.
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C.
Delirium and Lewy body dementia differ largely in their clinical manifestations.
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D.
Specific stroke types may likely to bring on delirium.
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A.
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3.
The following are true in the management of delirium, EXCEPT:
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A.
Potential side effects of antipsychotics (typical and atypical) include prolongation of the QTc interval.
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B.
Antipsychotics should be used short term until the delirium subsides.
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C.
Haloperidol in low dosage was in no way different to the atypical antipsychotics, olanzapine and risperidone in efficacy.
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D.
There is conclusive evidence to support pharmacological intervention for the prevention and management of delirium.
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A.
MCQ Answers
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1.
B
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2.
C
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3.
D
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Nagaratnam, K. (2019). Delirium in theĀ Oldest of Old. In: Nagaratnam, N., Nagaratnam, K., Cheuk, G. (eds) Advanced Age Geriatric Care. Springer, Cham. https://doi.org/10.1007/978-3-319-96998-5_32
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