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Delirium in Older Persons: Evaluation and Management - American Family Physician

Aug 1, 2014 - Delirium is defined as an acute, fluctuating syndrome of altered attention, awareness, and cognition. It is common in older persons in the hospital and long-term care facilities and may indicate a life-threatening condition. Assessment for and prevention of delirium should occur at ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0801/p150.html

Gait and Balance Disorders in Older Adults - American Family Physician

Jul 1, 2010 - Gait and balance disorders are common in older adults and are a major cause of falls in this population. They are associated with increased morbidity and mortality, as well as reduced level of function. Common causes include arthritis and orthostatic hypotension; however, most gait and ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0701/p61.html

Alzheimer Disease: Pharmacologic and Nonpharmacologic Therapies for Cognitive and ...

Jun 15, 2017 - Alzheimer disease comprises a syndrome of progressive cognitive and functional decline. Treatments should target cognitive and functional symptoms. Cholinesterase inhibitors, memantine, and a combination of a cholinesterase inhibitor and memantine have produced statistically significant...

American Family Physician : Article

https://www.aafp.org/afp/2017/0615/p771.html

Behavioral Disorders in Dementia: Appropriate Nondrug Interventions and Antipsychotic ...

Aug 15, 2016 - Behavioral and psychological symptoms of dementia pose management challenges for caregivers and clinicians. Firstline nonpharmacologic treatments include eliminating physical and emotional stressors, modifying the patient’s environment, and establishing daily routines. Family members ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0815/p276.html

Pharmacologic Management of Pain at the End of Life - American Family Physician

Jul 1, 2014 - Although many patients experience debilitating pain at the end of life, there are many options to improve analgesia and quality of life. Pain assessment using a validated tool, with attention to patient function and specific goals, helps tailor individual treatment plans. The World ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0701/p26.html

Evaluation of Suspected Dementia - American Family Physician

Oct 15, 2011 - As the proportion of persons in the United States older than 65 years increases, the prevalence of dementia will increase as well. Risk factors for dementia include age, family history of dementia, apolipoprotein E4 genotype, cardiovascular comorbidities, chronic anticholinergic use, ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1015/p895.html

Frontotemporal Dementia: A Review for Primary Care Physicians - American Family Physician

Dec 1, 2010 - Frontotemporal dementia (FTD) is one of the most common forms of dementia in persons younger than 65 years. Variants include behavioral variant FTD, semantic dementia, and progressive nonfluent aphasia. Behavioral and language manifestations are core features of FTD, and patients have ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1201/p1372.html

Behavior Disorders of Dementia: Recognition and Treatment - American Family Physician

Feb 15, 2006 - Psychosis may pose a greater challenge than cognitive decline for patients with dementia and their caregivers. The nature and frequency of psychotic symptoms varies over the course of illness, but in most patients, these symptoms occur more often in the later stages of disease. ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0215/p647.html

Diagnosing Dementia and Clarifying Goals of Care - Lown Right Care: Reducing Overuse ...

Sep 15, 2019 - A collaboration between AFP and the Lown Institute promotes a vision of delivering heath care that is based on the evidence, balanced in its approach, and focused on the patient.

American Family Physician : Lown Right Care: Reducing Overuse and Underuse

https://www.aafp.org/afp/2019/0915/p369.html

Evaluation and Management of Delirium in Hospitalized Older Patients - American Family ...

Dec 1, 2008 - Delirium is common in hospitalized older patients and may be a symptom of a medical emergency, such as hypoxia or hypoglycemia. It is characterized by an acute change in cognition and attention, although the symptoms may be subtle and usually fluctuate throughout the day. This ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1201/p1265.html

Mini-Mental State Examination for the Detection of Dementia in Older Patients - ...

Dec 1, 2016 - When scores are adjusted based on a patient's education level, the MMSE may be useful to rule out a diagnosis of dementia in clinically unevaluated patients 65 years and older (sensitivity = 97%; specificity = 70%). Scores of less than 24 may also be useful to rule in dementia in ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/1201/p880.html

Short-Term Antipsychotics for Alzheimer Disease - FPIN's Help Desk Answers - American ...

Apr 1, 2018 - Physicians should consider not using antipsychotics in patients with dementia. Patients with dementia, including Alzheimer disease, who are treated with antipsychotics for any length of time have a higher mortality rate than those not taking antipsychotics.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0401/od2.html

The AAFP Cognitive Care Kit: A Resource for Family Physicians - Editorials - American ...

Nov 15, 2017 - The AAFP Cognitive Care Kit was designed to give primary care physicians access to recommended materials to identify, screen, care for, and educate patients with cognitive impairment, as well as assist caregivers.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/1115/p630.html

Dementia Care: More Than Just Prescription Drugs - Editorials - American Family Physician

Jun 15, 2017 - Rather than focusing on medications to achieve a small temporary difference in cognition, patients and families might be better served if we focused more on nonpharmacologic treatments, and on more important issues, such as advance directives, driving, living arrangements, caregiver ...

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0615/p766.html

Alzheimer Disease: Monotherapy vs. Combination Therapy - FPIN's Help Desk Answers - ...

Apr 1, 2017 - Combination treatment with memantine and donepezil results in a small improvement in cognitive function that is of uncertain clinical significance in patients with moderate to severe Alzheimer disease, but no improvement in patients with mild to moderate disease.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/0401/p452.html

Dementia With Lewy Bodies: An Emerging Disease - American Family Physician

Apr 1, 2006 - Dementia with Lewy bodies appears to be the second most common form of dementia, accounting for about one in five cases. The condition is characterized by dementia accompanied by delirium, visual hallucinations, and parkinsonism. Other common symptoms include syncope, falls, sleep ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0401/p1223.html

Use of Atypical Antipsychotics in Patients with Dementia - American Family Physician

Jun 1, 2003 - Increasingly, atypical antipsychotic drugs are prescribed for elderly patients with symptoms of psychosis and behavioral disturbances. These symptoms often occur in patients with Alzheimer's disease, other dementias, or Parkinson's disease. As the average age of Americans increases, the...

American Family Physician : Article

https://www.aafp.org/afp/2003/0601/p2335.html

Older Adult Drivers with Cognitive Impairment - American Family Physician

Mar 15, 2006 - As the number of drivers with cognitive impairment increases, family physicians are more likely to become involved in decisions about cessation of driving privileges in older patients. Physicians who care for cognitively impaired older adults should routinely ask about driving status. ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0315/p1029.html

Diagnostic Approach to the Confused Elderly Patient - American Family Physician

Mar 15, 1998 - Confusion in the elderly patient is usually a symptom of delirium or dementia, but it may also occur in major depression and psychoses. Until another cause is identified, the confused patient should be assumed to have delirium, which is often reversible with treatment of the underlying ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0315/p1358.html

Screening for Cognitive Impairment in Older Adults - Putting Prevention into Practice -...

Jul 15, 2015 - N.D. is a 72-year-old white man who presents for a preventive visit. He smokes, and his medical history is significant for essential hypertension, which is stable and well controlled with medication. N.D.'s close friend was recently diagnosed with dementia, and N.D. is concerned that he...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2015/0715/p125.html

Screening for Cognitive Impairment in Older Adults: Recommendation Statement - U.S. ...

Mar 15, 2015 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for cognitive impairment.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2015/0315/od2.html

Benzodiazepines and Alzheimer Disease - AFP Journal Club - American Family Physician

Feb 1, 2015 - Benzodiazepine exposure over the preceding five years seems to be associated with an increased likelihood of an Alzheimer disease diagnosis. A dose-response gradient also seems to exist.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2015/0201/p191.html

Management of Normal Pressure Hydrocephalus - American Family Physician

Sep 15, 2004 - Gait instability, urinary incontinence, and dementia are the signs and symptoms typically found in patients who have normal pressure hydrocephalus. Estimated to cause no more than 5 percent of cases of dementia, normal pressure hydrocephalus often is treatable, and accurate recognition ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0915/p1071.html

Exercise Programs for Older Patients with Dementia - Cochrane for Clinicians - American...

Sep 1, 2014 - There is some evidence that exercise improves cognitive function and the ability to perform activities of daily living in patients with dementia.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2014/0901/p287.html

Dementia - Clinical Evidence Handbook - American Family Physician

Jan 15, 2014 - What are the effects of treatments on cognitive, behavioral, and psychological symptoms of dementia (Alzheimer disease, Lewy body dementia, or vascular dementia)?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2014/0115/p117.html

Cervical Spondylotic Myelopathy: A Common Cause of Spinal Cord Dysfunction in Older ...

Sep 1, 2000 - Cervical spondylotic myelopathy is the most common cause of spinal cord dysfunction in older persons. The aging process results in degenerative changes in the cervical spine that, in advanced stages, can cause compression of the spinal cord. Symptoms often develop insidiously and are ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0901/p1064.html

Pharmacologic Treatment of Alzheimer's Disease: An Update - American Family Physician

Oct 1, 2003 - Alzheimer's disease is characterized by the development of senile plaques and neurofibrillary tangles, which are associated with neuronal destruction, particularly in cholinergic neurons. Drugs that inhibit the degradation of acetylcholine within synapses are the mainstay of therapy. ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1001/p1365.html

Early Diagnosis of Dementia - American Family Physician

Feb 15, 2001 - Until recently, the most significant issue facing a family physician regarding the diagnosis and treatment of dementia was ruling out delirium and potentially treatable etiologies. However, as more treatment options become available, it will become increasingly important to diagnose ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0215/p703.html

Seizure Disorders in the Elderly - American Family Physician

Jan 15, 2003 - Seizure disorders become increasingly common after the age of 60 years and can have a significant impact on functional status. The goal of antiepileptic drug therapy is to control seizures but preserve quality of life. If possible, seizure control should be achieved with one agent given...

American Family Physician : Article

https://www.aafp.org/afp/2003/0115/p325.html

Guidelines for Managing Alzheimer's Disease: Part II. Treatment - American Family ...

Jun 15, 2002 - Once the clinical diagnosis of Alzheimer's disease has been made, a treatment plan must be developed. This plan should include cholinesterase inhibitor therapy to temporarily improve cognition or slow the rate of cognitive decline, management of comorbid conditions, treatment of ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0615/p2525.html

Antidepressants for Agitation and Psychosis in Patients with Dementia - Cochrane for ...

Jan 1, 2012 - There are few high-quality studies examining the effectiveness of antidepressants for treating the neuropsychiatric symptoms of dementia. Although there is some evidence to support the use of the selective serotonin reuptake inhibitors (SSRIs) sertraline (Zoloft) and citalopram ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2012/0101/p20.html

Guidelines for Managing Alzheimer's Disease: Part I. Assessment - American Family ...

Jun 1, 2002 - Family physicians play a key role in assessing and managing patients with Alzheimer's disease and in linking the families of these patients to supportive services within the community. As part of comprehensive management, the family physician may be responsible for coordinating ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0601/p2263.html

Cognitive Interventions for Improving Cognitive Function - Cochrane for Clinicians - ...

Nov 1, 2011 - Compared with no treatment, cognitive interventions improved cognitive performance in healthy older adults and older adults with mild cognitive impairments. However, there is inadequate evidence to determine which aspects of these interventions are effective.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2011/1101/p992.html

Donepezil to Manage Alzheimer Disease: New vs. Standard Dosing - AFP Journal Club - ...

Mar 15, 2011 - Does donepezil benefit patients with Alzheimer disease, and is the new dosage superior to the standard dosage? This study showed benefit, but the data are misleading.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2011/0315/p742.html

AAN Updates Guidelines on Evaluating Driving Risk in Patients with Dementia - Practice ...

Nov 1, 2010 - Quality Standards Subcommittee of the American Academy of Neurology (AAN) updated guidelines for the evaluation and management of driving risk in persons with dementia. The new evidence-based guidelines offer characteristics that can help to identify persons that are at risk of unsafe ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2010/1101/p1144.html

Senile Dementia of the Binswanger's Type - American Family Physician

Dec 1, 1998 - Senile dementia of the Binswanger's type is a term used to describe a dementia syndrome characterized by onset in the sixth or seventh decade of life, subcortical neurologic deficits, psychiatric disorders and evidence of hypertension or systemic vascular disease. The status of senile ...

American Family Physician : Article

https://www.aafp.org/afp/1998/1201/p2068.html

New Drugs for Alzheimer's Disease - American Family Physician

Oct 1, 1998 - Alzheimer's disease is characterized by degeneration of various structures in the brain, with development of amyloid plaques and neurofibrillary tangles. Deficiencies of acetylcholine and other neurotransmitters also occur. Pharmacologic treatment of the disease generally seeks to ...

American Family Physician : Article

https://www.aafp.org/afp/1998/1001/p1175.html

Delirium at the End of Life - Clinical Evidence Handbook - American Family Physician

May 15, 2010 - What are the effects of interventions at the end of life in persons with delirium caused by underlying terminal illness?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2010/0515/p1260.html

Brief Screening Instruments for Dementia in Primary Care - Point-of-Care Guides - ...

Mar 15, 2009 - In addition to identifying patients who may benefit from pharmacotherapy, early detection of dementia helps families anticipate the patient’s needs and helps physicians identify those in need of additional support.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2009/0315/p497.html

AAFP and ACP Release Guideline on Dementia Treatment - Practice Guidelines - American ...

Apr 15, 2008 - A guideline created by the American Academy of Family Physicians (AAFP) and the American College of Physicians (ACP) reviews the data on the effects of pharmacologic treatment of dementia for improving cognition, global function, behavior/mood, and quality of life (QOL)/activities of ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2008/0415/p1173.html

Quality of Life in Older Persons with Dementia Living in Nursing Homes - FPIN's ...

Apr 1, 2008 - There is no gold standard to measure the QOL in older persons with dementia. For those requiring increased care, nursing homes may offer some benefit, including more frequent physician assessment and treatment of pain and depression, compared with assisted living/residential care ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2008/0401/p1011.html

Predicting Delirium in Hospitalized Older Patients - Point-of-Care Guides - American ...

Nov 15, 2007 - Delirium is a common complication in hospitalized older patients, particularly in those in the intensive care unit.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2007/1115/p1527.html

Monitoring Therapy for Patients with Alzheimer's Disease - FPIN's Clinical Inquiries - ...

Jun 1, 2007 - Patients with Alzheimer's disease who undergo treatment of any kind should be monitored eight weeks after initiation of therapy and at least every six months thereafter.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2007/0601/p1703.html

Cholinesterase Inhibitors for Alzheimer's Disease - Cochrane for Clinicians - American ...

Sep 1, 2006 - Cholinesterase inhibitors produce a small benefit on several cognitive and noncognitive function scales. Although data for patients with severe dementia are sparse, there is no evidence to suggest a difference in effectiveness among patients with mild, moderate, or severe dementia. ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2006/0901/p747.html

New Guideline for Treatment of Dementia: Is There Really Anything New? - Editorials - ...

Apr 15, 2008 - Advertisement << Previous article Next article >> Apr 15, 2008 Issue Editorials New Guideline for the Treatment of Dementia: Is There Really Anything New? ALAN M. ADELMAN, MD, MS, Pennsylvania State University College of Medicine, Hershey, Pennsylvania DAVID R. MEHR, MD, MS,...

American Family Physician : Editorials

https://www.aafp.org/afp/2008/0415/p1080.html

Are Atypical Antipsychotics Safe in Patients with Alzheimer's Disease? - Cochrane for ...

Aug 1, 2006 - Although the atypical antipsychotic medications risperidone (Risperdal) and olanzapine (Zyprexa) are modestly efficacious in reducing aggression, routine use is not justified. Both drugs are associated with serious adverse cerebrovascular events and extrapyramidal symptoms. Use of ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2006/0801/p414.html

Donepezil in the Treatment of Vascular Dementia - Cochrane for Clinicians - American ...

Nov 1, 2004 - Donepezil in a dosage of 10 mg daily provides a small benefit in patients with mild to moderate vascular dementia and generally is well tolerated.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2004/1101/p1681.html

Screening for Dementia - Putting Prevention into Practice - American Family Physician

Oct 1, 2004 - Case study: RG, a 75-year-old, college-educated man, presents for an annual physical examination. His friend recently was diagnosed with Alzheimer’s disease. RG is concerned about his occasional memory lapses and is worried that he also has the disease.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2004/1001/p1329.html

Memantine (Namenda) for Moderate to Severe Alzheimer's Disease - STEPS - American ...

Mar 15, 2004 - Memantine is well tolerated, but its clinical benefits for the treatment of moderate to severe AD appear modest. The reduction in caregiver time requires confirmation in another trial. As with other drugs for AD, memantine does not reverse deterioration.

American Family Physician : STEPS

https://www.aafp.org/afp/2004/0315/p1491.html

Screening for Dementia: Recommendation and Rationale - U.S. Preventive Services Task ...

Mar 15, 2004 - This statement summarizes the U.S. Preventive Services Task Force (USPSTF) recommendations on screening for dementia and the supporting evidence, and it updates the 1996 recommendations contained in the Guide to Clinical Preventive Services, second edition.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2004/0315/p1473.html

Mild Cognitive Impairment in the Elderly - Editorials - American Family Physician

Feb 15, 2001 - Advertisement << Previous article Next article >> Feb 15, 2001 Issue Editorials Mild Cognitive Impairment in the Elderly JASON BRANDT, PH.D., Johns Hopkins University School of Medicine, Baltimore, Maryland Am Fam Physician. 2001 Feb 15;63(4):620-626. Related Article As physician...

American Family Physician : Editorials

https://www.aafp.org/afp/2001/0215/p620.html

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