Delirium: Reversible Syndrome in Older Adults

Delirium

• An acute-onset and reversible syndrome, common in older adults
• Characterized by inattention, inability to focus, drowsiness, confusion, agitation, hallucinations, and other cognitive changes
• May be caused by medication, acute illness, change in environment, or sleep disturbances
• Can last hours or days
• Depression can cause delirium

Parkinson's Disease

• A degenerative condition primarily affecting movement
• Causes tremors, rigidity, and gait disturbances, and can also affect speech
• Symptoms include tremor, rigidity, gait disturbances, and speech disturbances
• Can result in dementia due to lack of dopamine
• Characterized by shaking, unsteady gait, and feet sticking to the floor

Cerebrovascular Accident (Stroke)

• A vascular disease with neurological consequences
• Affects the opposite side of the body
• Causes paralysis, weakness, speech and vision impairments
• If treated immediately, neurological damage can be minimized or prevented

Cognitive Issues in Older Adults

• Episodic memory diminishes with age, affecting recall of information
• Free recall diminishes, making it difficult to remember unrelated items
• Working memory ability decreases, making it hard to multitask or comprehend complex information
• Semantic memory is maintained or may increase, allowing for long-term memory of how the world works
• Processing speed decreases, taking longer to recall memories

Renal Issues in Older Adults

• Increased risk of dehydration due to diminished thirst response
• Kidney changes lead to decreased thirst response and fear of incontinence
• Decreased excretion of medications and toxins, increasing the effect and side effects
• Risk of hyponatremia and hypernatremia due to nephron function decrease
• Increased risk of acid-base imbalance due to impaired renal diluting and concentrating ability
• Hypokalemia and hyperkalemia can occur from gastrointestinal losses and diuretic use
• Diarrhea can lead to acidosis, while vomiting can lead to alkalosis
• NG tube suctioning can put older adults at risk for alkalosis