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Chapter 36 - Management of the surgical patient with dementia

from Section 11 - Neurology

Published online by Cambridge University Press:  05 September 2013

By
Monica W. Parker ,
James J. Lah  and
Allan I. Levey
Edited by
Michael F. Lubin ,
Thomas F. Dodson  and
Neil H. Winawer
Michael F. Lubin
Affiliation:
Emory University, Atlanta
Thomas F. Dodson
Affiliation:
Emory University, Atlanta
Neil H. Winawer
Affiliation:
Emory University, Atlanta
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Summary

Improvement in medical care and lifestyle practice has resulted in greater life expectancy for American adults. In 2008, 39 million people aged 65 and over lived in the USA, accounting for 13% of the total population. This older population grew from 3 million in 1900 to 39 million in 2008. The “oldest-old” population grew from just over 100,000 in 1900 to 5.7 million in 2008 [1].

Older adults frequently have multiple medical problems that can result in an increased need for hospitalization and utilization of healthcare expenditures. Older age, cognitive impairment, polypharmacy, and functional and sensory impairment are risk factors most likely to result in postoperative delirium [2]. Geriatric patients with dementia are at higher risk for the development of delirium. Delirium costs are $38–$152 billion dollars per year [3]. Management of the surgical dementia patient is geared toward prevention of delirium. Delirium is prevented through the identification of dementia and preoperative management of risk factors. This will improve surgical outcomes, decrease length of hospitalization, and reduce healthcare costs.

Type
Chapter
Information
Medical Management of the Surgical Patient
A Textbook of Perioperative Medicine
 , pp. 396 - 403
Publisher: Cambridge University Press
Print publication year: 2013

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