Elucidating the pathophysiology of delirium dating tips for women from a man

Sleep-disordered breathing (SDB) is highly prevalent in the general population and has been associated with cognitive impairment in older individuals.Delirium is an acute decline in cognitive function and attention that often occurs after surgery, especially in older individuals.Usually combined with confusion; disorientation and environmental factors such as hospital stay may worsen this symptom.Studies have revealed that sleep and delirium coexist and both can cause or worsen the other.[2]Delirium presents with varying degrees of reversal of the sleep-wake cycle.

The incidence of postoperative delirium will likely also increase unless strategies for preventing it can be developed.DELIRIUM is a common and serious postoperative complication occurring in 5–15% of elderly patients after general anesthesia1 and up to 64% of patients undergoing spinal anesthesia for hip fracture surgery.2 Postoperative delirium is independently associated with increased mortality, duration of hospital stay, functional disability, placement in long-term care institutions, and hospitalization costs.3,4 It is estimated that delirium occurs in at least 20% of the 12.5 million individuals aged 65 yr or older who are hospitalized each year and increases the cost of hospitalization by ,500 for each patient who develops this complication.5,6 A study evaluating the total 1-yr healthcare costs for elderly individuals who developed delirium while hospitalized estimated that the national burden of delirium on the healthcare system may be as high as 2 billion each year.7 The etiology of postoperative delirium has not been clearly elucidated because it is a heterogeneous and multifactorial disorder involving a complex interrelation between a vulnerable patient with preoperative risk factors who is exposed to numerous precipitating factors in the perioperative period.5,8 A recent systematic review8 of the literature found that, although various studies have identified multiple risk factors of delirium, two previously validated prediction models9,10 remain helpful in identifying at-risk patients.Preexisting cognitive impairment (as measured with global mental status examinations) is the only item common to both of these predictive models and has been frequently cited as an important risk factor in numerous other studies.8 The systemic review8 also identified depression as a significant risk factor, and more recent studies in medical11 and surgical12,13 patients support the view that depressed elderly patients are at high risk for developing delirium.To investigate this hypothesis, preoperative patient risk factors for delirium were collected and patients were evaluated with neuropsychological tests before surgery to determine their preoperative cognitive status and level of depression.The impact of these factors was evaluated with a particular focus on identifying those cognitive measures most predictive of postoperative delirium.

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