Concussion is now known to be a significant public health issue, with high rates of emergency department visits and hospitalizations. Much of the current concern surrounding concussions revolves around recognition, early diagnosis, treatment modalities, return-to-play, and prevention of recurrent concussions.
A patient’s capacity to give informed consent or to leave the emergency department against medical advice is a topic of great relevance to emergency clinicians. This article discusses the difference between competence and capacity and highlights the four essential elements involved in the assessment of a patient’s capacity.
In a population-based longitudinal study of older individuals without dementia, the inclusion of imaging biomarkers for amyloid, tau, and neurodegeneration modestly improved the ability to predict memory decline compared to a model that only used clinical data and APOE genotype.
In a large, prospective, single-center study, more than one in six patients with acute brain injuries may have cognitive-motor dissociation (CMD) (e.g., they harbor capacity to modulate their brain activity in response to motor commands while remaining behaviorally unresponsive at the bedside). Some acute CMD patients were found to have a much higher chance for recovery of neurological functions and for reaching independent levels of activities of daily living by 12 months after brain injury.
A meta-analysis regarding mind-body techniques and cognitive fitness in older adults points to enhanced cognitive performance associated with mind-body interventions in older persons — especially those without preexisting cognitive decline.
Healthy older adults, as well as those with subjective cognitive impairment or meeting criteria for mild cognitive impairment, could consider including blueberries as part of a Mediterranean-like diet to help reduce the risk of cognitive decline.
Delirium is a complex disorder marked by the acute onset of mental status change with an associated fluctuating course. Despite the fact that delirium is a common clinical entity in elderly hospitalized patients, the condition may present in any patient regardless of medical comorbidities. Recognition within the emergency setting is becoming increasingly important, as the diagnosis frequently is missed.
Magnetic resonance imaging of the brain in community-dwelling people (average age of 60 years) found that a long-term, high-quality diet was associated with larger hippocampal volumes after an average interval of 11 years.