Description of the delirium and depressive disorders as factor complicating a diagnosis
Acute organic brain syndrome or the acute confusional state, otherwise known as delirium is neurocognitive impairment is commonly linked to physical illnesses in elderly people. There is a number of complications associated with the diagnosis of elderly patients, because of the changes in cognitive abilities and physical assets, frailty, dependence on medications, etc. In case of delirium some of those factors, for example, vision or hearing impairment can cause confusion in diagnosing delirium (Moraga & Rodriguez-Pascual, 2007).
One of the psychological disorders that tend to coexist with the delirium state is depressive disorders. The physical frailty and feeling of insecurity may result in the depressive disorders in elderly patients. However, depressive disorders might develop on the background of neurocognitive impairment, accompany it, or result in the delirium episode (Ely et al., 2004).
Factors and medications for elderly clients that complicate a diagnosis
The first factor in delirium diagnosis is global changes in cognition. The key factor is that it should not be misinterpreted as sensory impairment. Therefore, it presupposes reduced ability to sustain attention and disorganized speech (Tueth & Cheong, 1993). The second factor is elimination or confirmation of the accompanied psychological disorders. It will also help to assess the severity of delirium since some of the symptoms can be caused by psychological comorbid factor. The third factor is precipitation caused by the hospital environment, malnutrition, or dependence on medication (Moraga & Rodriguez-Pascual, 2007). The latter is important because the medication is the factor possible to control, even though it affects mood and cognitive abilities of patients. Therefore, over-medication in elderly patients can be confused with reduced neurocognitive functioning.
Ely, E. W., Shintani, A., Truman, B., Speroff, T., Gordon, S. M., Harrell Jr, F. E.,… & Dittus, R. S. (2004). Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. Jama, 291(14), 1753-1762.
Moraga, A. V., & Rodriguez-Pascual, C. (2007). Accurate diagnosis of delirium in elderly patients. Current opinion in psychiatry, 20(3), 262-267.
Tueth, M. J., & Cheong, J. A. (1993). Delirium: diagnosis and treatment in the older patient. Geriatrics, 48(3), 75-80.