Deciphering the 4 D's: Cognitive decline, delirium, depression and dementia - A review

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Purpose. The purpose of this paper is to assist advanced practice nurses to recognize, identify, and diagnose cognitive change in older adults. Background/rationale. Optimal cognitive function is important for continued independence, and yet changes in cognition are frequently unrecognized among older adults. Cognitive change in older adults can be observed due to age-related cognitive decline, the development of acute confusion (delirium), depression, dementia and/or a combination of these. When the aetiological source for alterations in cognitive function is delirium or depression, the potential for reversibility mandates that the reason for the cognitive change be identified with steps taken to remedy the situation. Also, early recognition of dementia is an important factor in obtaining timely and appropriate care. These conditions can exist concurrently and may fluctuate making deciphering the reason for the cognitive change problematic. Conclusions. It is essential to understand how the 4 'D,s' are expressed and to recognize the potential contributing factors to an observable change in cognitive function for diagnosis and treatment. Recommendations for obtaining a person's history are included.

Original languageEnglish (US)
Pages (from-to)360-368
Number of pages9
JournalJournal of Advanced Nursing
Volume38
Issue number4
DOIs
StatePublished - May 2002

Fingerprint

Delirium
Cognition
Dementia
Depression
Confusion
Nurses
Cognitive Dysfunction
Therapeutics

Keywords

  • Cognitive decline
  • Cognitive impairment
  • Delirium
  • Dementia
  • Depression
  • Elderly
  • Older adults

ASJC Scopus subject areas

  • Nursing(all)

Cite this

@article{9b82b5ae4eb441539293cac85b576556,
title = "Deciphering the 4 D's: Cognitive decline, delirium, depression and dementia - A review",
abstract = "Purpose. The purpose of this paper is to assist advanced practice nurses to recognize, identify, and diagnose cognitive change in older adults. Background/rationale. Optimal cognitive function is important for continued independence, and yet changes in cognition are frequently unrecognized among older adults. Cognitive change in older adults can be observed due to age-related cognitive decline, the development of acute confusion (delirium), depression, dementia and/or a combination of these. When the aetiological source for alterations in cognitive function is delirium or depression, the potential for reversibility mandates that the reason for the cognitive change be identified with steps taken to remedy the situation. Also, early recognition of dementia is an important factor in obtaining timely and appropriate care. These conditions can exist concurrently and may fluctuate making deciphering the reason for the cognitive change problematic. Conclusions. It is essential to understand how the 4 'D,s' are expressed and to recognize the potential contributing factors to an observable change in cognitive function for diagnosis and treatment. Recommendations for obtaining a person's history are included.",
keywords = "Cognitive decline, Cognitive impairment, Delirium, Dementia, Depression, Elderly, Older adults",
author = "Insel, {Kathleen C} and Badger, {Terry A}",
year = "2002",
month = "5",
doi = "10.1046/j.1365-2648.2002.02196.x",
language = "English (US)",
volume = "38",
pages = "360--368",
journal = "Journal of Advanced Nursing",
issn = "0309-2402",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - Deciphering the 4 D's

T2 - Cognitive decline, delirium, depression and dementia - A review

AU - Insel, Kathleen C

AU - Badger, Terry A

PY - 2002/5

Y1 - 2002/5

N2 - Purpose. The purpose of this paper is to assist advanced practice nurses to recognize, identify, and diagnose cognitive change in older adults. Background/rationale. Optimal cognitive function is important for continued independence, and yet changes in cognition are frequently unrecognized among older adults. Cognitive change in older adults can be observed due to age-related cognitive decline, the development of acute confusion (delirium), depression, dementia and/or a combination of these. When the aetiological source for alterations in cognitive function is delirium or depression, the potential for reversibility mandates that the reason for the cognitive change be identified with steps taken to remedy the situation. Also, early recognition of dementia is an important factor in obtaining timely and appropriate care. These conditions can exist concurrently and may fluctuate making deciphering the reason for the cognitive change problematic. Conclusions. It is essential to understand how the 4 'D,s' are expressed and to recognize the potential contributing factors to an observable change in cognitive function for diagnosis and treatment. Recommendations for obtaining a person's history are included.

AB - Purpose. The purpose of this paper is to assist advanced practice nurses to recognize, identify, and diagnose cognitive change in older adults. Background/rationale. Optimal cognitive function is important for continued independence, and yet changes in cognition are frequently unrecognized among older adults. Cognitive change in older adults can be observed due to age-related cognitive decline, the development of acute confusion (delirium), depression, dementia and/or a combination of these. When the aetiological source for alterations in cognitive function is delirium or depression, the potential for reversibility mandates that the reason for the cognitive change be identified with steps taken to remedy the situation. Also, early recognition of dementia is an important factor in obtaining timely and appropriate care. These conditions can exist concurrently and may fluctuate making deciphering the reason for the cognitive change problematic. Conclusions. It is essential to understand how the 4 'D,s' are expressed and to recognize the potential contributing factors to an observable change in cognitive function for diagnosis and treatment. Recommendations for obtaining a person's history are included.

KW - Cognitive decline

KW - Cognitive impairment

KW - Delirium

KW - Dementia

KW - Depression

KW - Elderly

KW - Older adults

UR - http://www.scopus.com/inward/record.url?scp=0036584344&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036584344&partnerID=8YFLogxK

U2 - 10.1046/j.1365-2648.2002.02196.x

DO - 10.1046/j.1365-2648.2002.02196.x

M3 - Article

C2 - 11985687

AN - SCOPUS:0036584344

VL - 38

SP - 360

EP - 368

JO - Journal of Advanced Nursing

JF - Journal of Advanced Nursing

SN - 0309-2402

IS - 4

ER -