ABSTRACT
ABSTRACT. Although hospitalization for dementia is increasing, Japanese doctors often refrain from surgeries considering dementia. A woman in her 80s diagnosed with Alzheimer's disease was admitted to hospital for cholelithiasis. Due to the avoidance of surgery, the inflammation was prolonged and therefore she was unable to eat. Later, she was discharged with central venous nutrition. The care burden on family resulted in her readmission to another hospital. Eventually, the inflammation was alleviated, and she was able to eat. However, it took a long time. In this study, we not only emphasize the risks but also focus on the benefits to postoperative rehabilitation. We also discuss about the benefits of invasive procedures in patients with dementia.
RESUMO. Apesar do aumento de hospitalizações por demência, os médicos japoneses geralmente se abstêm de cirurgias ao considerar a demência. Uma mulher de 80 anos diagnosticada com doença de Alzheimer foi internada no hospital por colelitíase. O adiamento da cirurgia prolongou a inflamação e a deixou incapaz de comer. Ela foi forçada a receber alta com nutrição venosa central. A sobrecarga de cuidados para a família resultou em sua readmissão em outro hospital. Eventualmente, a inflamação foi aliviada e ela conseguiu comer. No entanto, levou muito tempo. Não devemos apenas enfatizar os riscos, mas também focar nos benefícios da reabilitação pós-operatória. Gostaríamos aqui de discutir e fornecer argumentos a favor de procedimentos invasivos em pacientes com demência.
Subject(s)
Humans , Female , Aged, 80 and over , Dementia , Cognitive DysfunctionABSTRACT
The function of each organ including the brain tends to decline with aging. This influences on the appearance of psychotic symptoms in the elderly. A manic state in the elderly is often atypical and different from that in younger and middle aged patients. Manic pseudodementia is an important symptom, which means that elderly manic patients easily show dementia-like behavior because of their Tatendrang(pressured action) or hyperkinesis, so they are misdiagnosed as having dementia. On medication, as the response to drugs is different to that in younger patients, side effects easily appear in the elderly. However, we have very few clinical-pharmacological data on the use of major tranquilizers including anti-manic drugs for elderly patients.
