Encephalopathy in Elderly

Encephalopathy in Elderly

Encephalopathy is a condition of global brain dysfunction that manifests itself in a variety of clinical presentations, causes, and consequences and affects 10 to 40 percent of overall hospitalized patients(John et al., 2020). Mild confusion to sleepiness, stupor, and coma are all possible clinical profiles. There are several causes of encephalopathy, which can be reversible or permanent, benign or lethal. Injuries to the central nervous system, infections, metabolic imbalances, and organ failure are all common etiologies. Neurological reasons are the most prevalent etiologies of encephalopathy. The prognosis of encephalopathy in aged people varies, ranging from full recovery to irreversible brain damage or death, and is dependent on early identification and adequate care using laboratory tests and imaging.

Elderly people are more likely to present with encephalopathy following a brief febrile illness. Confusion (altered mental state) would be present in 2% of ED patients, 10% of all hospital in-patients, and up to 50% of elderly hospitalized patients, given that it is the hallmark of encephalopathy (Esme et al., 2019). Around 7 to 10 percent of elderly ED patients exhibit delirium. CNS infections are the most frequent cause of impaired mental state in people with nontraumatic coma. At the emergency room, many elderly patients with febrile encephalopathy do not have Brain infections, which is a problem for many doctors.

Given the difficulties in diagnosing older people with acute febrile encephalopathy (AFE), it might be better to establish guidelines on a clinical condition, such as AFE, rather than a disease category, such as bacterial meningitis (BM) (John et al., 2020). Moreover, prospective studies aimed at updating or verifying clinical indicators of CNS infection in senior patients are sought. Thus, it is essential to conduct prospective, carefully thought-out studies with the intent to assess the AFE etiologic diagnosis in senior patients and the appropriate flow of diagnostic and treatment approaches to promote the current practice.

References

Esme, M., Topeli, A., Yavuz, B. B., & Akova, M. (2019). Infections in the Elderly Critically-Ill Patients. Frontiers in Medicine, 6(118). https://doi.org/10.3389/fmed.2019.00118

John, B., Loomba, V., & John, M. (2020). Etiology, Clinical Profile and Outcome of Encephalopathy in Elderly. The Journal of the Association of Physicians of India, 68(3), 63–66. https://pubmed.ncbi.nlm.nih.gov/32138487/