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Baclofen, sold under the brand name Lioresal among others, is a medication used to treat muscle spasticity, such as from a spinal cord injury or multiple sclerosis. [8] [9] It may also be used for hiccups and muscle spasms near the end of life, [9] and off-label to treat alcohol use disorder [10] [11] or opioid withdrawal symptoms. [12]
Here's how to distinguish "sundowning"—agitation or confusion later in the day in dementia patients—from typical aging, from doctors who treat older adults.
A baclofen pump has been used to treat patients of all ages exhibiting muscle spasticity along with dystonia. The pump delivers baclofen via a catheter to the thecal space surrounding the spinal cord. The pump itself is placed in the abdomen. It can be refilled periodically by access through the skin. Baclofen can also be taken in tablet form [40]
When the steroid treatment ended after a year, the patent's confusion and disorganized appearance stopped immediately. Within several weeks, testing showed strong improvement in almost all cognitive functions. His doctors were surprised at the improvement, since the results were inconsistent with a diagnosis of dementia or Alzheimer's.
Baclofen, diazepam and dantrolene remain the three most commonly used pharmacologic agents in the treatment of spastic hypertonia. Baclofen is generally the drug of choice for spinal cord types of spasticity, while sodium dantrolene is the only agent which acts directly on muscle tissue. Tizanidine is also available.
POCD is common in adult patients of all ages at hospital discharge after major noncardiac surgery, but only the elderly (aged 60 years or older) are at significant risk for long-term cognitive problems. Patients with POCD are at an increased risk of death in the first year after surgery. [9]
Older patients are at a higher risk of experiencing CNS side effects. [ citation needed ] The link possible between anticholinergic medication use and cognitive decline/dementia has been noted in weaker observational studies. [ 21 ]
Alzheimer's patients demonstrate comparable abilities to encode information as healthy elderly adults, suggesting that impairments in encoding are not associated with confabulation. [34] However, as seen in Korsakoff's patients, confabulation in Alzheimer's patients is higher when prompted with questions investigating episodic memory.