The spectrum of psychocognitive morbidity in the critically ill: A review of the literature and call for improvement

Karnatovskaia, Lioudmila V.; Johnson, Margaret M.; Benzo, Roberto; Gajić, Ognjen

doi:10.1016/j.jcrc.2014.09.024

Cited by 76 publications

(74 citation statements)

References 79 publications

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“…Die generelle affektive Morbidität von Patienten, die eine akute kritische Erkrankung überlebt haben, ist in der Zeit nach einem Aufenthalt auf Intensivstation sehr hoch [2,3]. Die Prävalenzraten streuen in Abhängigkeit von der eingesetzten Methodik beträchtlich und sind am höchsten bei einer Bestimmung über Fragebögen.…”

Section: Prävalenz/inzidenzunclassified

“…Es bestehen sowohl auf der Ebene einer klinischen Syndromanalyse als auch auf der Ebene pathogenetischer Mechanismen wichtige Überschneidungen zwischen kognitiver und affektiver Morbidität [2,3].…”

Section: Kognitive Defiziteunclassified

“…Kognitive Defizite als Spätfolgen tragen eigenständig zu einer geminderten Lebensqualität bei. Sie reduzieren entscheidend die Fähigkeit, wieder zu einer geregelten beruflichen Tätigkeit zurückzukeh-ren, beeinträchtigen die Arbeitsproduktivität und die allgemeine Lebenszufriedenheit signifikant [2,3,36]. [41].…”

Section: Gesundheitsbezogene Lebensqualitätunclassified

“…B. Midazolam, Lorazepam) fördern die SchlafstadienI und II,sie unterdrückenabertiefere Schlafstadien und REM-Schlaf. Sie reduzieren den zerebralen Blutfluss und sind wahrscheinlich nicht nur mit häufigeren Deliren und kognitiven Dysfunktionen [46], sondern auch mit einer höheren Rate an depressiven und posttraumatischen Symptomen assoziiert [2,3,25].…”

Section: äTiopathogenetische Faktorenunclassified

“…Dieser erhöhte emotionale und kognitive Disstress während einer intensivmedizinischen Behandlung muss aber auch im Hinblick auf das erhöhte Risiko einer beträchtlichen kognitiven und affektiven Morbidität im weiteren poststationären Verlauf als relevant gewertet werden [3,24,26].…”

Section: Psychischer Disstress/störungen Als Risikoindikatorenunclassified

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Section: Prävalenz/inzidenzunclassified

Section: Kognitive Defiziteunclassified

Section: Gesundheitsbezogene Lebensqualitätunclassified

Section: äTiopathogenetische Faktorenunclassified

Section: Psychischer Disstress/störungen Als Risikoindikatorenunclassified

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Depressive, Angst- und posttraumatische Belastungsstörungen als Konsequenzen intensivmedizinischer Behandlung

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2021 Alzheimer's disease facts and figures

2021

Alzheimer's & Dementia

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This article describes the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality and morbidity, use and costs of care, and the overall impact on caregivers and society. The Special Report discusses the challenges of providing equitable health care for people with dementia in the United States. An estimated 6.2 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, the latest year for which data are available, making Alzheimer's the sixth‐leading cause of death in the United States and the fifth‐leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. This trajectory of deaths from AD was likely exacerbated in 2020 by the COVID‐19 pandemic. More than 11 million family members and other unpaid caregivers provided an estimated 15.3 billion hours of care to people with Alzheimer's or other dementias in 2020. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $256.7 billion in 2020. Its costs, however, extend to family caregivers’ increased risk for emotional distress and negative mental and physical health outcomes — costs that have been aggravated by COVID‐19. Average per‐person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are more than three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 23 times as great. Total payments in 2021 for health care, long‐term care and hospice services for people age 65 and older with dementia are estimated to be $355 billion. Despite years of efforts to make health care more equitable in the United States, racial and ethnic disparities remain — both in terms of health disparities, which involve differences in the burden of illness, and health care disparities, which involve differences in the ability to use health care services. Blacks, Hispanics, Asian Americans and Native Americans continue to have a higher burden of illness and lower access to health care compared with Whites. Such disparities, which have become more apparent during COVID‐19, extend to dementia care. Surveys commissioned by the Alzheimer's Association recently shed new light on the role of discrimination in dementia care, the varying levels of trust between racial and ethnic groups in medical research, and the differences between groups in their levels of concern about and awareness of Alzheimer's disease. These findings emphasize the need to increase racial and ethnic diversity in both the dementia care workforce and in Alzheimer's clinical trials.

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2022 Alzheimer's disease facts and figures

2022

Alzheimer's & Dementia

1,571

664

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This article describes the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality and morbidity, use and costs of care, and the overall impact on family caregivers, the dementia workforce and society. The Special Report discusses consumers' and primary care physicians' perspectives on awareness, diagnosis and treatment of mild cognitive impairment (MCI), including MCI due to Alzheimer's disease. An estimated 6.5 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, the latest year for which data are available. Alzheimer's disease was officially listed as the sixth-leading cause of death in the United States in 2019 and the seventh-leading cause of death in 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. More than 11 million family members and other unpaid caregivers provided an estimated 16 billion hours of care to people with Alzheimer's or other dementias in 2021. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $271.6 billion in 2021. Its costs, however, extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes -costs that have been aggravated by COVID-19. Members of the dementia care workforce have also been affected by COVID-19. As essential care workers, some have opted to change jobs to protect their own health and the health of their families. However, this occurs at a time when more members of the dementia care workforce are needed. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2022 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $321 billion. A recent survey commissioned by the Alzheimer's Association revealed several barriers to consumers' understanding of MCI. The survey showed low awareness of MCI among Americans, a reluctance among Americans to see their doctor after noticing MCI symptoms, and persistent challenges for primary care physicians in diagnosing MCI. Survey results indicate the need to improve MCI 700

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The spectrum of psychocognitive morbidity in the critically ill: A review of the literature and call for improvement

Cited by 76 publications

References 79 publications

Depressive, Angst- und posttraumatische Belastungsstörungen als Konsequenzen intensivmedizinischer Behandlung

Depressive, Angst- und posttraumatische Belastungsstörungen als Konsequenzen intensivmedizinischer Behandlung

2021 Alzheimer's disease facts and figures

2022 Alzheimer's disease facts and figures

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