Nichtmedikamentöse Konzepte zu Prävention und Behandlung eines Delirs

Thomas, Christine; Spank, Juliane; Weller, Sarah; Eschweiler, Gerhard W.

doi:10.1007/s00391-021-01988-3

Cited by 10 publications

(1 citation statement)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is astonishing as delirium has a high incidence (up to 50%) [87] in hospitalized geriatric patients and is associated with higher mortality, longer hospital stays and worse prognosis [88][89][90]. Although delirium prevention measures such as regular screening can prevent complications and improve patient prognosis [91], other studies have also found a lack of standardized approaches to delirium management [92,93]. Reasons include lack of time and staff, as well as a lack of knowledge about delirium and its management, for example, the choice of assessment tools and when to use them [92,93].…”

Section: Deliriummentioning

confidence: 99%

Which Comprehensive Geriatric Assessment (CGA) instruments are currently used in Germany: a survey

Kudelka,

Ollenschläger,

Dodel

et al. 2024

BMC Geriatr

View full text Add to dashboard Cite

Background The Comprehensive Geriatric Assessment (CGA) records geriatric syndromes in a standardized manner, allowing individualized treatment tailored to the patient’s needs and resources. Its use has shown a beneficial effect on the functional outcome and survival of geriatric patients. A recently published German S1 guideline for level 2 CGA provides recommendations for the use of a broad variety of different assessment instruments for each geriatric syndrome. However, the actual use of assessment instruments in routine geriatric clinical practice and its consistency with the guideline and the current state of literature has not been investigated to date. Methods An online survey was developed by an expert group of geriatricians and sent to all licenced geriatricians (n = 569) within Germany. The survey included the following geriatric syndromes: motor function and self-help capability, cognition, depression, pain, dysphagia and nutrition, social status and comorbidity, pressure ulcers, language and speech, delirium, and frailty. Respondents were asked to report which geriatric assessment instruments are used to assess the respective syndromes. Results A total of 122 clinicians participated in the survey (response rate: 21%); after data cleaning, 76 data sets remained for analysis. All participants regularly used assessment instruments in the following categories: motor function, self-help capability, cognition, depression, and pain. The most frequently used instruments in these categories were the Timed Up and Go (TUG), the Barthel Index (BI), the Mini Mental State Examination (MMSE), the Geriatric Depression Scale (GDS), and the Visual Analogue Scale (VAS). Limited or heterogenous assessments are used in the following categories: delirium, frailty and social status. Conclusions Our results show that the assessment of motor function, self-help capability, cognition, depression, pain, and dysphagia and nutrition is consistent with the recommendations of the S1 guideline for level 2 CGA. Instruments recommended for more frequent use include the Short Physical Performance Battery (SPPB), the Montreal Cognitive Assessment (MoCA), and the WHO-5 (depression). There is a particular need for standardized assessment of delirium, frailty and social status. The harmonization of assessment instruments throughout geriatric departments shall enable more effective treatment and prevention of age-related diseases and syndromes.

show abstract

Section: Deliriummentioning

confidence: 99%

Which Comprehensive Geriatric Assessment (CGA) instruments are currently used in Germany: a survey

Kudelka,

Ollenschläger,

Dodel

et al. 2024

BMC Geriatr

View full text Add to dashboard Cite

show abstract

Update on the diagnosis and treatment of delirium

Sadlonova

Arnim

2023

Innere Medizin

View full text Add to dashboard Cite

Delirium superimposed on dementia

Biasi

Reininghaus

Schoberer³

2022

Z Gerontol Geriat

View full text Add to dashboard Cite

Zusammenfassung Hintergrund Ein die Demenz überlagerndes Delir („delirium superimposed on dementia“, DSD) ist ein weit verbreitetes, aber häufig unerkanntes Problem. Ein solches Delir mindert die Lebensqualität von Patient/-innen mit einer Demenzerkrankung erheblich. Das Bewusstsein für dieses Zustandsbild muss bei Gesundheitsfachpersonen geschärft werden, um dessen Entwicklung frühzeitig erkennen und von Demenz ohne Delir unterscheiden zu können und dementsprechend zu behandeln. Ziel des Beitrages Dieser Review beschreibt den bisherigen Stand der erforschten diagnostischen, präventiven und therapeutischen Methoden im Umgang mit DSD. Material und Methoden Eine umfassende Literaturrecherche mit den Begriffen „Demenz“, „Delir“, „Delirium superimposed on dementia“ und „DSD“ wurde in der Datenbank PubMed durchgeführt, ebenso wie Literaturrecherchen über Google-Scholar. Ergebnisse Die diagnostischen Möglichkeiten zur Detektion von DSD sind zurzeit auf Instrumente zur alleinigen Delirdiagnostik beschränkt, wie etwa die Confusion Assessment Method. Ein regelmäßiges multiprofessionelles Screening der Risikopatient/-innen ist zur frühen Detektion und Prävention dieser Erkrankung essenziell. Auch die Behandlung erfordert einen interdisziplinären Zugang. Eine pharmakologische Therapie ist indiziert, wenn nichtpharmakologische Maßnahmen nicht ausreichen oder zur Behandlung von delirauslösenden Ursachen. Im Vordergrund stehen die psychische und physische Betreuung der Patient/-innen und die Beseitigung von Risikofaktoren für die Entwicklung eines DSD. Diskussion DSD ist ein ernst zu nehmendes Syndrom. Noch gibt es keinen Goldstandard in der Diagnostik und Therapie. Multikomponente nichtpharmakologische Interventionsprogramme reduzieren nachweislich die Inzidenz eines Delirs. Deren Nutzen bei DSD muss in großen multizentrischen Studien überprüft werden.

show abstract

Nichtmedikamentöse Konzepte zu Prävention und Behandlung eines Delirs

Cited by 10 publications

References 24 publications

Which Comprehensive Geriatric Assessment (CGA) instruments are currently used in Germany: a survey

Which Comprehensive Geriatric Assessment (CGA) instruments are currently used in Germany: a survey

Update on the diagnosis and treatment of delirium

Delirium superimposed on dementia

Contact Info

Product

Resources

About