Importance of Preventing Delirium in Hospitalized Older Adults

Journal of the American Geriatrics Society Research Summary

Though fever and respiratory problems are typically the most common symptoms of COVID-19, worrisome neurologic symptoms also occur in older adults. For example, in a study in Wuhan, China, 36 percent of older COVID patients had neurologic complaints, such as dizziness, pain, sleep disturbances, and problems with balance. Eight percent had impaired consciousness.

What’s more, geriatrics experts suggest that older age is also a risk factor for delirium, a term that means “sudden confusion.” Delirium refers to an abrupt, rapid change in mental function that goes well beyond the typical forgetfulness of aging. The result of abnormal functioning of the brain, delirium requires the attention of a healthcare professional.

Healthcare practitioners have seen delirium affect patients hospitalized with infectious diseases, including severe respiratory diseases. Delirium can mean that a person has suffered an acute brain failure, which could be caused by dehydration, psychoactive drugs, or infection. Delirium can increase the length of an older adult’s hospital stay and can cause mobility problems as well as difficulty thinking and making decisions. This can lead to older adults’ need for long-term care and raises their risk of death.

In severe cases, COVID-19 causes serious lung problems. When this happens to someone hospitalized for the virus, the patient may need mechanical ventilation to help them breathe, which can lead to delirium.

A recent study showed that 26 out of 40 patients with severe COVID-19 infection had signs of delirium. But despite this early evidence, we know little about the effects of delirium on people with COVID-19. A team of geriatrics experts from the University of Sao Paulo, Brazil, created a study to learn more about delirium in older adults hospitalized with COVID-19. Their study was published in the Journal of the American Geriatrics Society.

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Don’t Let Social Isolation Keep You from Being Active

Journal of the American Geriatrics Society Research Summary

By now, we’re all aware that COVID-19 is especially dangerous for older adults—the older you are, the higher your risk for serious illness and even death if you contract the virus. Because there is no treatment or a vaccine yet, it’s vitally important that we practice social distancing and wear masks to protect ourselves from disease.

But as we work to keep ourselves safe, we also need to be sure we’re not falling into physical inactivity. When we cut ourselves off from shopping, walking in malls, and going to the gym and other places where we can exercise, we can become sedentary. Older adults who don’t get regular exercise may become prone to chronic diseases, weakened muscles, and frailty.

Researchers from the University of Sao Paulo in Brazil recently reported on the dangers of physical inactivity for older adults during COVID-19. Their paper was published in the Journal of the American Geriatrics Society. Continue reading

Staying Safe as Your City Reopens: Friends and Neighbors May be Resuming Their Regular Activities—Should You?

Cities and counties across the country are beginning to ease or even end the regulations that closed stores, restaurants, businesses, services, and schools back in March 2020. But adults 65 years and older and those with chronic health conditions are still at high risk for contracting COVID-19 and facing its most serious complications, including death.

If you have underlying medical conditions, particularly if they are not well controlled, the CDC suggests that it’s wise to continue to maintain the highest level of vigilance about going out and resuming your regular activities. Some of the specific underlying health conditions noted by the CDC include:

  • Chronic lung disease
  • Moderate to severe asthma
  • Serious heart conditions
  • Being “immunocompromised”
    • People who are immunocompromised have a reduced ability to fight infections and other diseases.  Many things can cause a person to be immunocompromised, including cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications.
  • Severe obesity (body mass index [BMI] of 40 or higher)
  • Diabetes
  • Chronic kidney disease and undergoing dialysis
  • Liver disease

You can’t reduce your chances of contracting COVID-19 to zero. But if you understand the risks and use proven prevention measures, you may be able to help reduce the spread of the virus.

KEEP IN MIND: If you have COVID-19, have COVID-19 symptoms, or have been in close contact with someone who has COVID-19, you must stay home and away from other people. Talk to your healthcare provider about your specific precautions. When you can leave home and see others depends on different factors for different situations. Follow the CDC’s recommendations for your circumstances.

Here is the CDC’s science-based guidance for the best way to protect yourself as you begin to resume daily activities:

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COVID-19: My City is Reopening. How Can I Protect Myself?

You may be living in an area where local officials have decided it’s time to begin loosening restrictions that were put in place to slow the spread of COVID-19. While we can’t reduce our chances of becoming infected with the virus to zero, we can lower our risks and help reduce the coronavirus’ spread as restrictions are lifted.

If you’ve been diagnosed with COVID-19, have symptoms, or have been in close contact with someone who has COVID-19, it is important to stay home and away from other people. When can you leave home and be around other people? That depends on different factors for different situations. Follow the Centers for Disease Control and Prevention (CDC)’s recommendations for your circumstances.

As your area starts to reopen, your risk for contracting COVID-19 will be tied to several different factors. In general, the closer and longer you interact with others, the higher your risk of catching or spreading COVID-19. Ask yourself these questions: Continue reading

COVID-19: Addressing Elder Abuse, Social Isolation, and Other Key Concerns

By now, we’re all aware that COVID-19 poses heightened risks to older adults. The CDC reports that eight out of 10 deaths in the United States have been in people aged 65 and older.

But becoming infected with this potentially deadly virus isn’t the only risk that warrants our careful attention. Older adults face other COVID-19 related challenges, including issues that can impact emotional, physical, and even financial wellness. Reports of elder abuse (the mistreatment of someone because of their age) in its several terrible forms are sadly on the rise. But there are steps we can all take to help support those who need us.

“This is a test and I hope we pass it,” says Laura Mosqueda, MD. Dr. Mosqueda is Dean of the Keck School of Medicine, USC, and codirector of the National Center on Elder Abuse. Dr. Mosqueda shared her worries with us about the health and safety of older adults during this global pandemic. She is particularly concerned about four key issues that target older adults.

Social Isolation

“To me, what’s really interesting right now is that we know that the dangers of social isolation are really significant for older adults. In fact, we’ve been making all kinds of public health statements about just how dangerous social isolation is,” Dr. Mosqueda notes. “And now we’re telling everyone to socially isolate and to practice social distancing.”

Vulnerability to Financial Abuse

Because of this social isolation, older adults are now potentially more vulnerable to things like financial scams. This is because they may no longer have friends or family members dropping in regularly. According to Dr. Mosqueda, “these days, when an older adult just needs to get a home repair or something done, they don’t have as many people around who might be advocating for their best interests.” Continue reading