Derouesné Christian, Lacomblez Lucette
Service de pharmacologie, Université Pierre et Marie Curie, Groupe Hospitalier Pitié-Salpêtrière, Paris.
Psychol Neuropsychiatr Vieil. 2007 Mar;5(1):7-16.
Delirium is very common in the elderly. It complicates both psychiatric and somatic disorders and is associated with reduced survival, poor functional results, increased duration of hospital stay, and institutionalization. Diagnosis remains difficult in spite of the improvement of the diagnostic criteria, due to the polymorphism of the clinical signs and fluctuation of vigilance and cognition. Age over 70 and previous cognitive impairment are the main risk factors. Precipitating factors are medical and surgical pathologies, intoxications, especially by therapeutic drugs. Delirium can reveal or complicate a previous dementia. Prevention of delirium and care of the delirious patient require the participation of both the medical and nursing staff.
谵妄在老年人中非常常见。它使精神疾病和躯体疾病都变得复杂,并且与生存率降低、功能预后不良、住院时间延长以及入住养老院有关。尽管诊断标准有所改进,但由于临床症状的多态性以及警觉性和认知的波动,诊断仍然困难。70岁以上的年龄和既往认知障碍是主要危险因素。诱发因素包括内科和外科疾病、中毒,尤其是治疗药物中毒。谵妄可能会揭示先前的痴呆症或使其复杂化。预防谵妄和护理谵妄患者需要医护人员的共同参与。