Geriatric Neuropsychiatry

Common syndromes addressed are Depression (a fixed and severe negative emotional state), Dementia (a loss of intellectual ability that is often progressive) and Delirium (rapidly developing confusion often due to a general physical illness). The neuropsychiatrist uses formal testing of cognition (how information is stored and processed in the brain) in combination with a focused neurological exam and laboratory studies (e.g., bloodwork and images of the brain) to diagnose and manage the behavior changes seen in conditions such as Alzheimer’s, Stroke, Parkinson’s Disease, and Traumatic Brain Injury. These conditions can often be accompanied by frightening hallucinations, delusional beliefs, aggression, and sleep/wake disruption. Often these behavioral changes are the most concerning issues for family members and can escalate to a crisis situation if not addressed early on. Several medication options are available with variable benefits depending on their specific indication, however, removal of offending medications when possible can often be just as helpful. Increased supervision and modification of the living environment are often needed, but these interventions can be limited by community and financial resources. Beyond a certain degree of impairment, the patient themselves can lose a rational awareness of their situation. This makes ongoing collaboration between the caregiver, family members, and physician even more essential as efforts to clarify therapeutic goals and maximize quality of life are made.