ABSTRACT
Delirium is common and is commonly misdiagnosed, chiefly in being missed (Bhat and Rockwood, 2007). The consequences of misdiagnosis are often severe and wide ranging, affecting patients, caregivers, health professionals, and hospitals (Inouye et al., 2014). Many an older hospitalized person with delirium is trapped in the interface between psychiatry and the rest of medicine, and can too easily be caught in the tendentious battles between treating teams. Both researchers and policymakers have sought to improve this unacceptable state of affairs (Young et al., 2010; Tieges et al., 2015).
Subject(s)
Delirium/diagnosis , Diagnostic Errors , Hospitals, General , Mental Disorders/diagnosis , Patient Care Management , Aged , Diagnosis, Differential , Diagnostic Errors/adverse effects , Diagnostic Errors/prevention & control , Early Diagnosis , Geriatric Assessment/methods , Hospitals, General/methods , Hospitals, General/standards , Humans , Mental Status and Dementia Tests , Patient Care Management/methods , Patient Care Management/standards , Staff DevelopmentABSTRACT
PURPOSE OF REVIEW: There has been increasing research into the role of nutritional factors in mood and cognitive disorders in later life. This review evaluates findings from recent research for the role and effect of n-3 polyunsaturated fatty acids (PUFAs) and B vitamins in mood and cognitive disorders in later life. RECENT FINDINGS: Epidemiological studies, including genetic epidemiological ones, continue to provide support for the role of folate and/or vitamin B12 in mood disorders in later life. However, evidence from recent randomized controlled trials for the effect of these B vitamins and n-3 PUFAs is modest. There is little robust evidence for the effect of these nutrients on cognitive disorders in later life. SUMMARY: Larger randomized controlled trials allowing more appropriate meta-analyses are required to further evaluate current findings. Additionally, methods derived from research in geriatric medicine may assist in conceptualizing a role for these nutrients.
Subject(s)
Diet/methods , Dietary Fats , Fatty Acids, Unsaturated , Fishes , Folic Acid , Mental Disorders/diet therapy , Mental Disorders/drug therapy , Aged , Animals , Cognition Disorders/complications , Cognition Disorders/drug therapy , Folic Acid/therapeutic use , Folic Acid Deficiency/complications , Folic Acid Deficiency/drug therapy , Geriatric Psychiatry/methods , Humans , Mood Disorders/complications , Mood Disorders/drug therapy , Nutritional Status , Vitamin B 12/therapeutic use , Vitamin B 12 Deficiency/complications , Vitamin B 12 Deficiency/drug therapy , Vitamin B Complex/therapeutic useABSTRACT
PURPOSE OF REVIEW: Nutritional issues have received little attention in geriatric psychiatry research. This review focuses on literature published in 2003 and 2004 on nutritional factors in mental illness in the elderly and proposes directions for future research. RECENT FINDINGS: There has been more research on the role of micronutrients in psychiatric disorders of older adults but studies examining nutritional state in this population are lacking. The former research suggests associations between low folic acid/vitamin B12 status and depression in older adults whereas evidence for other micronutrients is still tentative. In the latter work, there is only one study that examines malnutrition in psychogeriatric patients despite the availability of well-validated screening tools for assessing nutritional state in the elderly and the known impact of undernutrition in ageing and the development of frailty. The role of obesity in ageing is also relevant especially as more people with schizophrenia live longer, although the current evidence in the non-mentally ill elderly suggests that being overweight may have protective effects in the elderly. SUMMARY: Malnutrition is likely to have considerable impact on the mental and physical state of the elderly.
