Psychiatria senectutis

Psychiatria senectutis est psychiatriae subdisciplina, quae morbos animae atque pertubationes personalitatis senioris senilisque investigat et describit atque iuvat, ut qualitas vitae aegrotoru melior fiat. Dementia (e. g. Morbus Alzheimerianus) etenim dementia incipiens^[1]^[2], depressio (sive "depressio senectutis" sive depressio cum morbo Parkinson conexa) atque paranoea et status confusionales magnum pondus habent. Praeterea numerosa sunt momenta aliarum medicinae disciplinarum, quae in senectute cum symptomatibus mentis pathologicis apparere possunt. Collaboratio igitur cum aliis disciplinis senes examinando et curando magni momenti est.

Cave: notitiae huius paginae nec praescriptiones nec consilia medica sunt.

Morbi psychogeriatrici

Dementiae

Conferatur pagina principalis: Dementia.

Depressio senilis

In literatura medica depressio in senectute ab ceteris depressionibus separatur, si initium symptomatum depressionis post sexuaginta quinque annos natum aestimetur. Notio depressionis in senectute internationalis LOD (late-onset-depression) est. Gradus symptomatum voluminibus hippocamporum diminutis velut aliis mutationibus neuropathologicis pendent^[3].

Morbi aliarum medicinae disciplinarum symptomata mentis efficientes

In senecetute symptomata psychopathologiae non solum ex morbis mentis, sed potius ex aliis morbis vel ex effectibus adversisoriuntur medicamentorum vel ex morborum disciplinarum medicinae aliarum ostendunt.

Senectus et psychopharmacologia

Homines seniores facile in polypharmaciae periculum delabuntur^[4]^[5]. Opus pharmacologorum anno 2017 editum senioribus in valetudinario octo medicamentos perscribi demonstravit, inter quae duo psychopharmaca^[6]. Magis magisque hic et usus benzodiazepinorum addubitatur^[7].

Medicina conservativa

In senectute numerus morborum, qui singularem senem iminuunt, maior est et sic pariter gradus imminuendi est: multimorbiditas. Quamquam non raro symptomata typica cuiusque morbi absunt. Per exemplum pneumonia in senectute febri vel tachypnoea carent, sed pro eo delirium adest.

Ophthalmologia

Oculorum morbi ad mentis commutationes mirissimas ducere possunt. Glaucoma vel cataracta senilis enim imaginum oculorum naturam deminuunt, ut sulcus calcarineus cerebri (area 17, 18, 19) commeatus optici inopia ipse imagines proprias conficiat: vividissimae scaenae imprimis noctu senes perterrere possunt.

Perturbationes personalitatis in senectute

Cicero

 At sunt morosi et anxii et iracundi et difficiles senes.

in opere de senectute suo scripsit. At personalitatis perturbationes in cursu senectutis augent^[8]. Praevalentia tamen mutationum apud senes centesimae 3 – 13 aestimatur^[9]. Praecipue in dementia frontotemporalis aegrotorum personalitates mature graviterque mutantur. Non raro depressio assistit, vel mors voluntaria^[10].

Scalae et indices

Ad gradus morborum statuumve describendum plures scalae et indices divulgatae sunt, per exemplum:

Scala depressionis geriatrica (GDS) — folium interrogativum triginta (sive quindecim) quaestionum ad depressionem in senectute dignoscendum adhibitum
Index Barthel — descriptio decem facultatum cotidianarum

Nexus interni

Notae

↑ Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E (1999). "Mild cognitive impairment: clinical characterization and outcome". Arch. Neurol. 56 (3): 303–8
↑ Winblad B, Palmer K, Kivipelto M (2004). "Mild cognitive impairment - beyond controversies: report of the International Working Group on Mild Cognitive Impairment". J Intern Med 256: 240-246
↑ Jamieson A., Goodwill A. M., Termine M., Campbell S., Szoeke C. (May 2019). "Depression related cerebral pathology and its relationship with cognitive functioning: A systematic Review". Journal of affective disorders 250: 410-8
↑ von Moltke LL, Greenblatt DJ, Romach MK, Sellers EM (sep 2001). "Cognitive toxicity of drugs used in the elderly". Dialogues Clin Neurosci 3: 181-90
↑ Beers MH, Ouslander JG, Rollingher I, Reuben DB, Brooks J, Beck JC (Sep 1991). "Explicit criteria for determining inappropriate medication use in nursing home residents. UCLA Division of Geriatric Medicine.". Arch Intern Med 151: 1825-32
↑ Sander K., Förster E., Laux G (2017). Das medikamentöse Verordnungsverhalten bei älteren und chronisch kranken Patienten in stationär-psychiatrischer Behandlung folgt einer altersangemessenen Pharmakotherapie. Psychopharmakotherapie 24: 21-31. (Theodisce)
↑ Societas geriatrica Americana: sapienter delectum habere ... (Anglice)
↑ Martin P, Long MV, Poon LW (2002). "Age changes and differences in personality traits and states of the old and very old". J Gerontol Psychol Sci 57B: 144-52
↑ Van Alphen SP, Engelen GJ, Kuin Y, Derksen JJ (Mar 2006). "The relevance of a geriatric sub-classification of personality disorders in the DSM-V". Int J Geriatr Psychiatry 21: 205-9
↑ Kjølseth I, Ekeberg O, Steihaug G (Oct 2009). ""Why do they become vulnerable when faced with the challenges of old age?" Elderly people who committed suicide, described by those who knew them". Int Psychogeriatr 21: 903-12

Bibliographia

Steffens, David C., Blazer, Dan G. et Thakur, Mugdha E. (2015). The American Psychiatric Publishing Textbook of Geriatric Psychiatry (Liber definitivus psychiatriae senectutis). American Psychiatric Publishing, ISBN 978-1585624843 (Anglice)

Nexus externi

stipula

Haec stipula ad medicinam spectat. Amplifica, si potes!

[pmid10190820-1] Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E (1999). "Mild cognitive impairment: clinical characterization and outcome". Arch. Neurol. 56 (3): 303–8

[2] Winblad B, Palmer K, Kivipelto M (2004). "Mild cognitive impairment - beyond controversies: report of the International Working Group on Mild Cognitive Impairment". J Intern Med 256: 240-246

[3] Jamieson A., Goodwill A. M., Termine M., Campbell S., Szoeke C. (May 2019). "Depression related cerebral pathology and its relationship with cognitive functioning: A systematic Review". Journal of affective disorders 250: 410-8

[4] von Moltke LL, Greenblatt DJ, Romach MK, Sellers EM (sep 2001). "Cognitive toxicity of drugs used in the elderly". Dialogues Clin Neurosci 3: 181-90

[5] Beers MH, Ouslander JG, Rollingher I, Reuben DB, Brooks J, Beck JC (Sep 1991). "Explicit criteria for determining inappropriate medication use in nursing home residents. UCLA Division of Geriatric Medicine.". Arch Intern Med 151: 1825-32

[6] Sander K., Förster E., Laux G (2017). Das medikamentöse Verordnungsverhalten bei älteren und chronisch kranken Patienten in stationär-psychiatrischer Behandlung folgt einer altersangemessenen Pharmakotherapie. Psychopharmakotherapie 24: 21-31. (Theodisce)

[7] Societas geriatrica Americana: sapienter delectum habere ... (Anglice)

[8] Martin P, Long MV, Poon LW (2002). "Age changes and differences in personality traits and states of the old and very old". J Gerontol Psychol Sci 57B: 144-52

[9] Van Alphen SP, Engelen GJ, Kuin Y, Derksen JJ (Mar 2006). "The relevance of a geriatric sub-classification of personality disorders in the DSM-V". Int J Geriatr Psychiatry 21: 205-9

[10] Kjølseth I, Ekeberg O, Steihaug G (Oct 2009). ""Why do they become vulnerable when faced with the challenges of old age?" Elderly people who committed suicide, described by those who knew them". Int Psychogeriatr 21: 903-12

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