Diagnosis and management of dementia in older people

Dementia is a leading cause of morbidity and death in the UK. Diagnostic criteria exist for the different aetiologies and subtypes. Alzheimer’s disease is the most common type and there is evidence of benefit from acetylcholinesterase inhibitors for some people living with Alzheimer’s disease. Care for people living with dementia in hospital and in the community needs improvement. Non-pharmacological means of managing distress people living with dementia should be prioritized over the use of antipsychotic and sedative medications, and greater focus on symptom management towards the end of life is required.

Delirium in older adults

Delirium is a serious and common syndrome characterized by acute deterioration of mental status. Patients show attentional deficits and commonly also altered levels of arousal and psychotic features. Detection can be assisted through use of validated tools such as the 4AT. Delirium is associated with multiple adverse outcomes including patient and carer distress, increased length of hospital stay, risk of future dementia, new institutionalization and death. Old age, dementia and frailty are the main predisposing factors, but there are a number of modifiable risk factors that are important within hospital environments.

Chemists discover the structure of a key coronavirus protein

Chemists have determined the molecular structure of a protein found in the SARS-CoV-2 virus. This protein forms a cation-selective channel and plays a key role in the virus’s ability to replicate itself. If researchers could devise ways to block this channel, they may be able to reduce the pathogenicity of the virus and interfere with viral replication.