Posted on 12/06/2008 9:43:59 PM PST by neverdem
By Rick Nauert, Ph.D. Senior News Editor Reviewed by John M. Grohol, Psy.D.
Tuesday, Oct 21 (Psych Central) -- In a groundbreaking study, Duke University physicians have developed a method to identify the risk of postoperative confusion.
Authorities believe the screening tool will help minimize or prevent what has become an increasingly serious medical problem among older adults.
Delirium, which is sometimes accompanied by confused speech and hallucinations, is known to leave patients in an acute confused state where they experience a serious decline in cognition and attention.
It is believed that up to 50 percent of older adults experience delirium and disorientation following general anesthesia. With the current looming increase in elderly patients, researchers have expressed significantly increased interest in identifying risk factors that will help identify older patients best suited for preoperative intervention measures.
Aside from the detrimental impact patients personally experience with postoperative delirium, the economic repercussions resulting from longer hospital stays, elevated rates of admission to long-term care institutions, higher death rates and related healthcare costs are staggering. In 2004 alone, it was estimated that nearly $6.9 billion Medicare dollars were spent treating delirium.
For purposes of this study, the team from Duke submitted 100 patients 50 years or older undergoing noncardiac surgery to a screening for geriatric depression and a battery of five preoperative tests designed to measure their ability to process information, concentrate and self monitor. Postoperative delirium occurred in 16 percent of patients after surgery.
The results of the study indicated that the most reliable independent predictors of postoperative delirium were the geriatric depression score and the time required to complete the Trails B portion of what is known as the Trail Making Test – a cognitive flexibility task designed to measure perception, judgment, memory and so on in a shifting environment.
According to Dr. Monk, “This study demonstrates that a short preoperative cognitive test battery consisting of a depression and an executive function test requiring less than 10 minutes may help identify patients at greatest risk for postoperative delirium.”
While these patients appeared to function normally prior to surgery, it is believed that they may have had some loss of critical brain mass that was not obvious without neurocognitive testing which may account for their predisposition for postoperative delirium.
Dr. Monk and her team view this study as an important first step in developing a practical and predictable screening tool that will help identify at risk patients for preoperative interventions and simultaneously reduce healthcare costs associated with the increased occurrences of delirium that might otherwise be expected with an aging population.
Source: American Society of Anesthesiologists
Later
That's a bit strong, don't ya think.
Are you by any chance familiar with Dr. Reams and the Reams Biological Theory of Ionization?
Very interesting post. Thanks.
It is most comforting = especially since I regularly take a magnesium/calcium (proportionately balanced) and B's - along with Co-Q10, folic and cod liver oil - the latter in capsules, thank you! And I take pro-biotics on and off. (the only prescrip. I take is enalapril)
I haven't taken milk thistle for a long time, but I think I'll get some.
I really appreciate your advice and encouragement.
Another elderly neighbor, that passed away a few years ago,
took NO prescription drugs. The only thing she used was a low dose coated aspirin...and B-12 shots.
Her doctor had her on B-12 shots. (she had the vials at home for self injection - although a health nurse came to do it for her as she was squeamish.)
She loved her meat, hated veggies, loved butter, drank red rose tea regularly and her cocktails more so!
She sailed through a gall bladder op - at age 100 - with NO residual effects - sharper than the proverbial tack. (She was a "proper" little English lady and could tell jokes that would make a truck driver blush!)
She died at 103 - not from illness - but simply decided she's seen enough. Her heart, liver and all were in excellent condition!
Decades ago, I had a doctor that prescribed B-12 for me - he said I didn't absorb B-12 properly. It really seemed to do me good. (long ago and in another state)
My present doc dismisses the need. ;o(
I can see magnesium being "farmed out" of the soil, but aren't B Vitamins organic chemicals made in the plants. Now I suppose their might be some precursor that is "farmed out", but the B vitamins themselves?
No, no, no! This is the kind of verbosity we need here at FR! Now that you're here, you'll quickly see that not all of the verbosity that is posted is as knowledgeable, eloquent and valuable as yours is.
Welcome to Free Republic, hope you'll like it here :-)
You must be under 50.
Higher organic material, such as manure, has been shown to increase the plants vitamin content. More importantly, farming practices involving use of pesticides has been shown to adversely affect the B content.
I have read material suggesting that some of these nutritional components are needed by the plants to fight off infestations of insects. When pesticides are applied they short circuit the plants requirement for protection and therefore decrease it's ability to assimilate these nutrients. There are more lengthy articles but for a quick synopsis... http://www.nutrasunfoods.com/nutrition/organic/pesticides
It is a sad fact that medical practitioners have very little training in nutrition.
Elderly people have a very hard time with absorption of nutrients because the same nutrients they are deficient in are the ones required to make the enzymes to properly digest and assimilate food. It becomes a vicious cycle resulting in disease.
Additionally, many older people, because of the indigestion that accompanies the lack of enzymes for digestion, are placed on antacid preparations such as Prevacid. This makes it difficult for the body to make it's B12(manufactured in the stomach due to intrinsic factor) because an ACIDIC environment is required to create B12. This nutrient is not well absorbed orally (in vitamin supplements) and must be taken sublingually or by injection.
I couldn't agree more that the medical profession and the clients it serves would benefit greatly from more practitioners proficient on nutrition's role in disease processes.
There is a push to adjust these recommendations. The amount of Vitamin D is under review as the RDA has been way below what is required for most people. I hope we see some changes soon.
I think this is happening as people take charge of their health more frequently.
I totally agree that it makes no sense for the RDA to be the minimal amount before disease occurs. Our bodies sustain a lot of damage before we actually start to exhibit physical or mental symptoms.
It's time to shoot for Optimum health instead of lack of illness.
The reasons why a good pro-biotic is necessary are many. B vitamins are produced by certain bacteria in the gut.The good bacterias crowd out the bad bacteria to prevent inflammation of the bowel with the resulting issue of “leaky gut syndrome”. This is when large particles (such as full proteins) cross over into the bloodstream. Because these are considered foreign substances by the body, the immune system is activated and the damaging processes of inflammation are set up in the body. (Think allergies, asthma,etc.)
The latest research keeps pointing to inflammation as the precursor to most disease states. Perhaps that is why low dose aspirin has been effective in such things as heart disease. Brenda Watson is a health practitioner who has written some easy to read books on these subjects which are loaded with information.
I started taking the folic acid and periodically, homeopathic anti inflammatories, some years ago after reading research on it and homocysteine.
I had a heart attack almost 12 years ago....and was diagnosed with CHF..
I was put on 3 prescripts. I continued to drag around and have periodic trips to the ER, overnighters, 2 years of edema - feet and ankles puffed up like balloons, squeezing chest, etc.
I had adverse side effect to 2 of the meds and stopped them. In researching the other, I found - I think it was a Mayo Clinic study (I'm careful about ‘advice’) I found the med I was on was good for heart disease “except for CHF!” - another (enalapril was recommended. I printed the study out and took it to my doctor. He switched meds for me. I stuck to that. Also, I used to be an investigative reporter and that, along with my innate nosiness, led me to more research. Which is how I came up with the folic/Co-Q10/cold liver oil/hawthorne/b’s etc.
I gradually felt better and then markedly better. I haven't had any problems with edema for years...used to be daily. I haven't had any ER episodes for years.
I now have a new doctor who wasn't around for the years of trouble, tests, xrays, echo-grams, etc. Even though he has the records, he questioned them as I was getting BETTER, not progressively worse. He did NOT want to hear anything about herbs/supplements. Would brush it off with, like CoQ10, “Well, I suppose it can't do any harm”
Last summer, he ordered another echo-gram. Everything looks so good “for my age” (I'm a gramma 15 times) that he now doubts I ever had a heart attack, ;o) I do, however, really like him - he's not a pill pusher - and we get along great.AGain, I really, really appreciate your input!
Actually I turned 57 in November.If you think 57 is "middle aged" (as in the middle of life) how many 114 year old people do you know?
Thank you dianed. I’m seeing a trail of info on the internet and on FR about the importance of magnesium. I’ve been diagnosed with osteopenia and my mother has advanced osteoporosis (four bad breaks in four years).
Welcome to Freerepublic! :)
I think it's difficult for people to understand that their medical practitioner works for THEM. They feel uncomfortable taking too much time or think the questions they ask would seem foolish.
Would anyone hesitate to ask their lawyer questions about an issue they were involved in? I certainly wouldn't know the first thing about what to do with a lawsuit, but I would demand quality service from my lawyer.
So, keep it up, it's people like you who are great examples that will eventually force the medical community to change when the public demands better service. Stay well....
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