Abstract:
BACKGROUND AND OBJECTIVES:Psychiatric symptoms in dementia and delirium are associated with a substantially reduced quality of life of patients and their families and often challenging for professionals. Pharmacoepidemiological surveys have shown that, in particular, patients living in nursing homes receive prescriptions of psychotropic agents in significant higher frequency than recommended by current guidelines. This article focuses on a critical appraisal of this gap from the point of view of German healthcare services. MATERIAL AND METHODS:Narrative review with special reference to the German dementia guideline from 2016 and recently published practice guidelines for delirium in old age in German and English language. RESULTS:The indications for use of psychotropic agents, especially antipsychotics, are defined narrowly in the German dementia guideline. According to this guideline for several psychopathological symptoms evidence based recommendations cannot be given, currently. For delirium several practice guidelines related to different treatment settings have been published recently. Comparable to the German dementia guideline they recommend general medical interventions and nonpharmacological treatment as first line measures and the use of psychotropic agents only under certain conditions. These guidelines differ to some extent regarding the strength of recommendation for psychopharmacological treatment. CONCLUSION:The guidelines discussed here advocate well-founded a cautious prescription of psychotropic agents in patients with dementia and delirium. This contrasts to everyday practice which is characterized by significantly higher prescription rates. This gap may explained partially by a lack of evidence-based recommendations regarding certain psychopathological symptoms. Most notably, however, epidemiological data disclose an unacceptable rate of hazardous overtreatment with psychotropic agents, especially in long-term care of persons with dementia. In this situation counteractive measures by consequent implementation of the principles of good clinical practice in geriatrics are required urgently.
journal_name
Z Gerontol Geriatrjournal_title
Zeitschrift fur Gerontologie und Geriatrieauthors
Hewer W,Thomas Cdoi
10.1007/s00391-016-1176-0subject
Has Abstractpub_date
2017-02-01 00:00:00pages
106-114issue
2eissn
0948-6704issn
1435-1269pii
10.1007/s00391-016-1176-0journal_volume
50pub_type
杂志文章,评审abstract::Symptoms presented by patients with Alzheimer-type dementia do not only reflect organic disturbances only but require a holistic and person-oriented view. Affective and behavioral disturbances are not necessarily secondary to cognitive impairment. Guidelines are presented for a multidimensional treatment involving the...
journal_title:Zeitschrift fur Gerontologie und Geriatrie
pub_type: 杂志文章,评审
doi:10.1007/s003910170072
更新日期:2001-04-01 00:00:00
abstract::The treatment and care of individuals with dementia, who are admitted to general hospitals due to somatic diseases, often leads to crisis situations which not only compromise the therapeutic benefit, but also can be followed by avoidable institutionalization in nursing homes or psychiatric hospitals. With the model pr...
journal_title:Zeitschrift fur Gerontologie und Geriatrie
pub_type: 杂志文章
doi:10.1007/s00391-008-0021-5
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abstract::The geriatric screening according to AGAST (Arbeitsgruppe Geriatrisches Basisassessment) contains functional and diagnosis related items, and risk indicators of prognostic relevance, particularly in hospitalized patients. In a retrospective, cohort study, we compared the screening results in 250 consecutive patients o...
journal_title:Zeitschrift fur Gerontologie und Geriatrie
pub_type: 杂志文章
doi:10.1007/s00391-003-0098-9
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Aged skin is the sum of chronological und UV-induced aging. Light-exposed skin is unattractive, with irregular pigmentation, roughness und scaliness. The skin is often dry and itches. METHODS:The present paper provides an overview of diseases of aging skin and describes how to prevent or reduce disease by p...
journal_title:Zeitschrift fur Gerontologie und Geriatrie
pub_type: 杂志文章,评审
doi:10.1007/s00391-014-0670-5
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abstract:BACKGROUND:Research regarding effective collaboration and communication between professional caregivers and dermatologists and the need for further education and training for caregivers in the field of geriatric dermatology still remains relatively scarce. OBJECTIVE:To document the state of knowledge of professional c...
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pub_type: 杂志文章
doi:10.1007/s00391-016-1132-z
更新日期:2018-01-01 00:00:00
abstract::The number of accidents caused by older car drivers increases annually in Germany. Typical errors of older drivers concern the right of way, changes of direction and conflicts with pedestrians at cross walks. These errors are attributed to deficient information gathering and processing caused by old age and illness. I...
journal_title:Zeitschrift fur Gerontologie und Geriatrie
pub_type: 杂志文章
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journal_title:Zeitschrift fur Gerontologie und Geriatrie
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journal_title:Zeitschrift fur Gerontologie und Geriatrie
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journal_title:Zeitschrift fur Gerontologie und Geriatrie
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journal_title:Zeitschrift fur Gerontologie und Geriatrie
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abstract::The purpose of the study was to measure the prevalence of difficulties in elderly inpatients in opening a range of common commercial drug packagings, in breaking a bar-scored tablet, and in reading medication instructions. Sixty-seven patients (female: 47; male: 20, mean age: 81.6 +/- 6.1) who reported that they had m...
journal_title:Zeitschrift fur Gerontologie und Geriatrie
pub_type: 杂志文章
doi:
更新日期:1995-11-01 00:00:00
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journal_title:Zeitschrift fur Gerontologie und Geriatrie
pub_type: 杂志文章
doi:10.1007/s00391-011-0169-2
更新日期:2011-08-01 00:00:00
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journal_title:Zeitschrift fur Gerontologie und Geriatrie
pub_type: 临床试验,杂志文章
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更新日期:2013-01-01 00:00:00
abstract::Heating of food induces the formation of Maillard reaction products (MRPs) caused by the reaction of reducing sugars with proteins or amino acids. Analogous reactions occur in the human body, eventually forming "Advanced Glycation Endproducts" (AGEs). AGEs accumulate in aging tissues accelerating degenerative-inflamma...
journal_title:Zeitschrift fur Gerontologie und Geriatrie
pub_type: 杂志文章,评审
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journal_title:Zeitschrift fur Gerontologie und Geriatrie
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doi:10.1007/s00391-013-0524-6
更新日期:2014-11-01 00:00:00
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journal_title:Zeitschrift fur Gerontologie und Geriatrie
pub_type: 杂志文章
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更新日期:1998-12-01 00:00:00
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journal_title:Zeitschrift fur Gerontologie und Geriatrie
pub_type: 杂志文章
doi:10.1007/s00391-011-0223-0
更新日期:2011-08-01 00:00:00
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journal_title:Zeitschrift fur Gerontologie und Geriatrie
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journal_title:Zeitschrift fur Gerontologie und Geriatrie
pub_type: 杂志文章
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更新日期:2012-01-01 00:00:00
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journal_title:Zeitschrift fur Gerontologie und Geriatrie
pub_type: 杂志文章
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更新日期:2016-07-01 00:00:00
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journal_title:Zeitschrift fur Gerontologie und Geriatrie
pub_type: 杂志文章,评审
doi:
更新日期:1997-05-01 00:00:00
abstract::Patients with Graves' or Plummer's disease have usually definitively been treated by surgery or radioiodine. If, however, the patient does not accept either form of treatment or the risk of surgery or the inconveniences of the radioiodine treatment by far out-weight the expected benefit for the patient, alternative th...
journal_title:Zeitschrift fur Gerontologie und Geriatrie
pub_type: 杂志文章,评审
doi:
更新日期:1997-07-01 00:00:00
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journal_title:Zeitschrift fur Gerontologie und Geriatrie
pub_type: 杂志文章
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更新日期:2002-08-01 00:00:00
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journal_title:Zeitschrift fur Gerontologie und Geriatrie
pub_type: 杂志文章
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更新日期:2018-01-01 00:00:00
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journal_title:Zeitschrift fur Gerontologie und Geriatrie
pub_type: 杂志文章
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更新日期:2001-10-01 00:00:00
abstract::The incidence and prevalence of chronic renal disease (CKD) in elderly patients are continuously increasing worldwide. Loss of renal function is not only considered to be part of the aging process itself but also reflects the multimorbidity of many geriatric patients. Calculating the glomerular filtration rate using s...
journal_title:Zeitschrift fur Gerontologie und Geriatrie
pub_type: 杂志文章
doi:10.1007/s00391-016-1109-y
更新日期:2016-08-01 00:00:00
abstract::Further education in practical, clinical and scientific-theoretical gerontology is of great importance either for the global care of the elderly or to increase the knowledge concerning the problems of aging. In this paper we try to evaluate critically activities referring to this, to furthermore develop in internation...
journal_title:Zeitschrift fur Gerontologie und Geriatrie
pub_type: 杂志文章
doi:
更新日期:1997-03-01 00:00:00