当前位置： SCI文献检索 > AGE AND AGEING期刊下所有文献 > New horizons in the pathogenesis, assessment and management of delirium.

New horizons in the pathogenesis, assessment and management of delirium.

Abstract：

UNLABELLED:Delirium is one of the foremost unmet medical needs in healthcare. It affects one in eight hospitalised patients and is associated with multiple adverse outcomes including increased length of stay, new institutionalisation, and considerable patient distress. Recent studies also show that delirium strongly predicts future new-onset dementia, as well as accelerating existing dementia. The importance of delirium is now increasingly being recognised, with a growing research base, new professional international organisations, increased interest from policymakers, and greater prominence of delirium in educational and audit programmes. Nevertheless, the field faces several complex research and clinical challenges. In this article we focus on selected areas of recent progress and/or uncertainty in delirium research and practice. (i) PATHOGENESIS:recent studies in animal models using peripheral inflammatory stimuli have begun to suggest mechanisms underlying the delirium syndrome as well as its link with dementia. A growing body of blood and cerebrospinal fluid studies in humans have implicated inflammatory and stress mediators. (ii) PREVENTION:delirium prevention is effective in the context of research studies, but there are several unresolved issues, including what components should be included, the role of prophylactic drugs, and the overlap with general best care for hospitalised older people. (iii) ASSESSMENT:though there are several instruments for delirium screening and assessment, detection rates remain dismal. There are no clear solutions but routine screening embedded into clinical practice, and the development of new rapid screening instruments, offer potential. (iv) MANAGEMENT:studies are difficult given the heterogeneity of delirium and currently expert and comprehensive clinical care remains the main recommendation. Future studies may address the role of drugs for specific elements of delirium. In summary, though facing many challenges, the field continues to make progress, with several promising lines of enquiry and an expanding base of interest among researchers, clinicians and policymakers.

journal_name

Age Ageing

journal_title

Age and ageing

authors

Maclullich AM,Anand A,Davis DH,Jackson T,Barugh AJ,Hall RJ,Ferguson KJ,Meagher DJ,Cunningham C

doi

10.1093/ageing/aft148

subject

Has Abstract

pub_date

2013-11-01 00:00:00

pages

667-74

issue

eissn

0002-0729

issn

1468-2834

pii

aft148

journal_volume

pub_type

杂志文章,评审

在线工具

New horizons in the pathogenesis, assessment and management of delirium.