Kwak Min Ji
Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Ann Geriatr Med Res. 2021 Sep;25(3):150-159. doi: 10.4235/agmr.21.0082. Epub 2021 Aug 30.
Delirium and frailty are prevalent geriatric syndromes and important public health issues among older adults. The prevalence of delirium among hospitalized older adults ranges from 15% to 75%, while that of frailty ranges from 12% to 24%. The exact pathophysiology of these two conditions has not been clearly identified, although several hypotheses have been proposed. However, these conditions are considered to be multifactorial in etiology and are associated with inflammation related to aging, alterations in vascular systems, genetics, and nutritional deficiency. Furthermore, clinically, they are significantly associated with frailty, which increases the risk of delirium by almost two- to three-fold among hospitalized older adults. With their multifactorial etiology and unknown pathophysiology, current evidence supports more practical multicomponent patient-centered approaches to prevent and manage delirium with frailty among hospitalized older adults. These comprehensive and organized bundled approaches can identify high-risk patients with frailty and more effectively manage their delirium.
谵妄和衰弱是常见的老年综合征,也是老年人中重要的公共卫生问题。住院老年人中谵妄的患病率在15%至75%之间,而衰弱的患病率在12%至24%之间。尽管已经提出了几种假说,但这两种情况的确切病理生理学尚未明确确定。然而,这些情况在病因上被认为是多因素的,并且与衰老相关的炎症、血管系统改变、遗传学和营养缺乏有关。此外,在临床上,它们与衰弱显著相关,这使住院老年人发生谵妄的风险增加了近两到三倍。由于其多因素病因和未知的病理生理学,目前的证据支持采用更实用的以患者为中心的多组分方法来预防和管理住院老年人中伴有衰弱的谵妄。这些全面且有组织的综合方法可以识别出衰弱的高危患者,并更有效地管理他们的谵妄。