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What Causes Increased Cognition Deterioration In Elderly While Suffering From Infections?
Question: My mother in law is 88, mentation is changing. Seems more lethargic, not sure of day and time, laughs in appropriately, sleeps a lot, talks of scenarios not quite real. Moved recently to assisted living where developed UTI, untreated for over a week or more, though we kept pressing for urine sample. Also more SOB, so given Lasix and K a couple of times. She has not seen a physician in 3weeks when she was completely fine and totally appropriate and clear!
Three days ago MD put her on 2 antibiotics , Cipro and Amoxicillin. She is on multiple meds:
Toprol, Vasotec, Norvasc, cardizem, Lexipro, remeron,levothyroxine, olanzapine, Plavix, Advair.
Under care of Primary and Cardiologist, I'm wondering if too many interactions between meds.
In past , she does ok for awhile then acts as if she is emotionally unstable. That's why assisted living with extra assists. Never tested for dementia, but MD believes she has frontal temporal lobe dementia. Has had PM hallucinations but that seems controlled. I'm worried we are not being vigilant enough. She has been known to act out to get what she wants/needs but won't ask. Her son is going for open heart surgery next week and I'm afraid there will be a crisis for her!!! Is it the antibiotics???
Three days ago MD put her on 2 antibiotics , Cipro and Amoxicillin. She is on multiple meds:
Toprol, Vasotec, Norvasc, cardizem, Lexipro, remeron,levothyroxine, olanzapine, Plavix, Advair.
Under care of Primary and Cardiologist, I'm wondering if too many interactions between meds.
In past , she does ok for awhile then acts as if she is emotionally unstable. That's why assisted living with extra assists. Never tested for dementia, but MD believes she has frontal temporal lobe dementia. Has had PM hallucinations but that seems controlled. I'm worried we are not being vigilant enough. She has been known to act out to get what she wants/needs but won't ask. Her son is going for open heart surgery next week and I'm afraid there will be a crisis for her!!! Is it the antibiotics???
Brief Answer:
Not related to antibiotics.
Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Based on your query, my opinion is as follows:
1. During infections, elderly would have increased cognition deterioration. As she is now recovering from infection, it will take time.
2. This cognition deterioration is seen at present in increased lethargy, day-night variation, and hallucinations.
3. This is not due to the antibiotics at present. However, additionally - medications being used like olanzapine, remeron and lexipro could have similar effects.
4. Once she recovers, it will take around a month for her to improve to her previous self. She requires extra care, which is being provided for her in assisted living.
5. Yes, her sons condition might affect her severely and this could still worsen the condition as it would be a bigger stressor. Not sure, how much she would be able to understand due to her present mentation, but it could deteriorate further and it could take very long for her to recover.
6. Need to continue with regular medication and support. Good care taker support and family involvement could help in faster recovery. Hygiene, hydration and nutrition is very important.
Hope it helps.
Any further queries, here to help again.
Dr. Prakash HM
Not related to antibiotics.
Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Based on your query, my opinion is as follows:
1. During infections, elderly would have increased cognition deterioration. As she is now recovering from infection, it will take time.
2. This cognition deterioration is seen at present in increased lethargy, day-night variation, and hallucinations.
3. This is not due to the antibiotics at present. However, additionally - medications being used like olanzapine, remeron and lexipro could have similar effects.
4. Once she recovers, it will take around a month for her to improve to her previous self. She requires extra care, which is being provided for her in assisted living.
5. Yes, her sons condition might affect her severely and this could still worsen the condition as it would be a bigger stressor. Not sure, how much she would be able to understand due to her present mentation, but it could deteriorate further and it could take very long for her to recover.
6. Need to continue with regular medication and support. Good care taker support and family involvement could help in faster recovery. Hygiene, hydration and nutrition is very important.
Hope it helps.
Any further queries, here to help again.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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