Geriatrie

Gériatrie

Délirium:

Delirium detection in the emergency department: A diagnostic accuracy meta-analysis of history, physical examination, laboratory tests, and screening instruments. Carpenter CR, Lee S, Kennedy M, Arendts G, Schnitker L, Eagles D, Mooijaart S, Fowler S, Doering M, LaMantia MA, Han JH, Liu SW.  Acad Emerg Med. 2024 May 16. doi: 10.1111/acem.14935. Epub ahead of print. PMID: 38757369.

The 4 'A's Test (4AT) is reasonably accurate in ruling out delirium in adults 65 and older, POEM, 23 juillet 2021

Two bedside tests are fairly accurate in screening for delirium in older patients, POEM, 3 décembre 2018

The Diagnosis of Delirium Superimposed on Dementia: An Emerging Challenge, J Am Med Dir Assoc. 2017 Jan; 18(1): 12–18. Published online 2016 Sep 16. doi:  [10.1016/j.jamda.2016.07.014]

Serial Administration of a Modified Richmond Agitation and Sedation Scale for Delirium Screening, J Hosp Med. 2012 May-Jun; 7(5): 450–453. Published online 2011 Dec 15. doi:  [10.1002/jhm.1003]

    Modified RASS Scale  N.B. Un changement dans l'état de base de la démence est un indice d'un délirium.

    

CAM score

CAM, version française

Mini-Cog

Six item screener - SIS: ÉchelleArticle

Incidence of delirium in the Canadian emergency department and its consequences on hospital length of stay: a prospective observational multicentre cohort study, Émond M, Boucher V, Carmichael P, et al, BMJ Open 2018;8:e018190. doi: 10.1136/bmjopen-2017-018190 

Antipsychotics for Preventing Delirium in Hospitalized Adults: A Systematic Review. Oh ES, Needham DM, Nikooie R, Wilson LM, Zhang A, Robinson KA, Neufeld KJ. Ann Intern Med. 2019 Sep 3. doi: 10.7326/M19-1859. [Epub ahead of print]

Conclusion: Current evidence does not support routine use of haloperidol or second-generation antipsychotics for prevention of delirium. There is limited evidence that second-generation antipsychotics may lower the incidence of delirium in postoperative patients, but more research is needed. Future trials should use standardized outcome measures.

Démence

Benefits and Harms of Prescription Drugs and Supplements for Treatment of Clinical Alzheimer-Type Dementia, Ann Intern Med. 2020 May 19;172(10):656-668. doi: 10.7326/M19-3887. Epub 2020 Apr 28.

Antipsychotic use in dementia: a systematic review of benefits and risks from meta-analyses, Ther Adv Chronic Dis. 2016 Sep; 7(5): 229–245. 

Optimisation de la pharmacothérapie chez les personnes âgées qui présentent un déficit cognitif, Facteurs dont les cliniciens de première ligne doivent tenir compte, Linda Lee, Tejal Patel, Frank Molnar and Dallas Seitz, Canadian Family Physician September 2018, 64 (9) e366-e372; 

Use of Antipsychotics in Behavioural and Psychological Symptoms of Dementia (BPSD) Discussion Guide, Primary Care 1st Edition, Centre for Effective Practice

Antipsychotics and Dementia, Centre for Effective Practice

Accuracy of Dementia Screening Instruments in Emergency Medicine - A Diagnostic Meta-Analysis. Acad Emerg Med. 2018 Sep 17. doi: 10.1111/acem.13573. [Epub ahead of print]

Five-year risk of admission to long-term care home and death for older adults given a new diagnosis of dementia: a population-based retrospective cohort study, Gregory Huyer, Catherine R.L. Brown, Sarah Spruin, Amy T. Hsu, Stacey Fisher, Douglas G. Manuel, Susan E. Bronskill, Danial Qureshi, Peter Tanuseputro, CMAJ Apr 2020, 192 (16) E422-E430; DOI: 10.1503/cmaj.190999

Dépression

Validation of a brief screening tool to detect depression in elderly ED patients, The American Journal of Emergency Medicine, Volume 20, Issue 2, March 2002, Pages 99-102

ED-DSI score

Évaluation fonctionnelle

Detection of Older People at Increased Risk of Adverse Health Outcomes After an Emergency Visit: The ISAR Screening Tool, Journal of the American Geriatrics Society, Volume 47, Issue 10, October 1999, Pages 1229–1237 

Calculateur score ISAR

Baseline Functional Assessment Tool, Mount Sinai Hospital

KARNOFSKY PERFORMANCE STATUS SCALE DEFINITIONS RATING (%) 

ECOG Performance Status 

Médication

American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel. J Am Geriatr Soc. 2019 Jan 29. doi: 10.1111/jgs.15767. [Epub ahead of print]

A POCKET GUIDE TO THE AGS 2015 BEERS CRITERIA