Lege Artis Medicinae

[Our stubborn misbeliefs on ageing ]

RAJNA Péter1

JANUARY 20, 2019

Lege Artis Medicinae - 2019;29(01-02)

DOI: https://doi.org/10.33616/lam.29.002

[Stressing the continuous increase of elderly population, the author demonstrates the negative impact of technical development on everyday routines of old population. It can explain that members of younger generations often create false ideations on mental and cognitive abilities of older ones, and consequently some stubborn misbeliefs are existing here. He deals with the following four of them in details: (1) Young age means worth, while old age is equal to deficit, (2) Every old person becomes demented, (3) Elderly people loose their interest and social sensitivity, (4) Old people means ballast for younger ones. The author emphasizes, that even the elderly persons are able to fall into these traps of misbeliefs. In addition to complex refutations, he states that the “spacecraft-model” described by L. Hayflick offers efficient solutions to preserve an adequate quality of life both for old people and their society. ]


  1. Semmelweis Egyetem, Pszichiátriai és Pszichoterápiás Klinika



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[What brings ICD-11 to psychiatry? ]


[On 18 June 2018, after 10 years of working the World Health Organization released the 11th edition of International Clas­si­fi­cation of Diseases. User-friendly development was a definite goal. For the first time, it is completely electronic. The renewal in regard to both formal and content aspects reflects dynamic development of medicine. It contains new chapters on immune sys­tem disorders, sleep disorders, sexual health and traditional medicine. The new edition contains 55000 possible codes. It comes to effect from January 2022 in the member states and that requires users, doctors, insurers, and universities to be well prepared. Coding of mental and behavioral disorders also changes significantly. Fol­lo­wing a brief general description we look at the most important changes in the field of psychiatry. ]

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[Anxiety is one of the most common psychological disorders in the elderly. Physical illnesses contribute to its development, but the opposite is also true: anxiety adversely affects the prognosis of many somatic illnesses, thus significantly enhancing morbidity and mortality. Therefore, the recognition and adequate treatment of anxiety disorders in the elderly are especially important in family practice, too. With the increase of life expectancy, the problems and illnesses of the elderly receive more and more attention in medical practice and anxiety cannot be ignored either, because the early detection of its symptoms improves the quality of life and reduces the chance of bad prognosis. ]

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[The goal of treatment of dementia-related disorders is to reserve cognitive and functional ability, minimize behavioral and psychological disturbances, and slow disease progression, since currently available therapies can not reverse the pathologic processes. Among them, the most common is Alzheimer’s disease and vascular dementia. The authors review the therapeutic guidelines of these dementia types adapted to Hungarian conditions. Cho­li­nesterase inhibitors represent first-line therapy for patients with mild to moderate Alzheimer’s disease, whereas a glutamate N-metil-D-aspartate antagonist is used in the treatment of moderate to severe Alzheimer’s disease. In milder stages, phar­macotherapy may be supplemented by the use of nootropics. The progression slowing drugs have not only impact on cognitive symptoms but also affect behavioral and psychological symptoms. De­pen­ding on the severity of dementia and the existence of behavioral and psychological symptoms, these medicines may be re­commended as monotherapy or in combination. To further alleviate behavioral and psychological symptoms a variety non-pharmacological methods are known, at present their effectiveness has not been proven. Antipsychotics may be used to reduce agitation and aggression. Taking into account the side effects profile of antipsychotics, tiapride or risperidon ad­mi­nistration can be considered. In the case of their ineffectiveness, haloperidol may be used. ]

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[This summarizing paper demonstrates the main elements and tasks of severe dementia care of patients. Dementia care is provided on three levels of competence: level of specialist’s, that of physician’s and of caregiver’s/supporter’s. Because of increasing gravity of tasks during the progression of dementia the caregivers become(s) risk-persons from psychopathological points of views. The most important tasks of the everyday care are summarized in tables and the main factors of predominantly emotional character, which can limit the results are also demonstrated. Application of some up-to-date institutional solutions, which can optimize the patients’ care is also listed. Supposing an ever increasing burden of dementia care, author delivers an important message also for members of the younger generations. ]

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