Psychosis in Hospitalized Elderly: Identifying Risk Factors and Implementing Preventive Strategies

• DOI: https://doi.org/10.22533/at.ed.1594962429102

• Palavras-chave: Elderly psychosis; Hospitalization risk factors; Polypharmacy complications; Cognitive impairment in elderly; Psychosis prevention strategies.

• Keywords: Elderly psychosis; Hospitalization risk factors; Polypharmacy complications; Cognitive impairment in elderly; Psychosis prevention strategies.

• Abstract: INTRODUCTION The introduction discussed the increasing prevalence of psychosis in hospitalized elderly patients and the complex interplay of risk factors, including cognitive decline, polypharmacy, and the hospital environment. It emphasized the diagnostic challenges in distinguishing psychosis from delirium and outlined the importance of understanding the pathophysiology and contributing factors for effective prevention and management. OBJETIVE The primary objective of this review was to analyze the risk factors contributing to the development of psychosis in hospitalized elderly patients, focusing on the roles of cognitive decline, polypharmacy, sensory impairments, and hospital-related stressors. The goal was to identify preventive measures and management strategies that could reduce the incidence and severity of psychosis in this population. METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Psychosis in elderly” OR “Hospitalization and mental health” OR “Polypharmacy in geriatric patients” OR “Cognitive decline and psychosis” OR “Preventive measures for hospital psychosis”in the last  years. RESULTS AND DISCUSSION The results and discussion highlighted the multifactorial nature of psychosis in hospitalized elderly patients, focusing on the roles of neurodegenerative processes, medication interactions, infections, and environmental stressors in exacerbating psychotic symptoms. Preventive strategies, such as careful medication management, addressing sensory impairments, and modifying the hospital environment, were emphasized. The discussion also touched upon the need for individualized, multidisciplinary approaches to care, incorporating both pharmacological and non-pharmacological interventions. CONCLUSION The conclusion reiterated the complexity of managing psychosis in elderly hospitalized patients, emphasizing the importance of early detection, targeted interventions, and preventive measures. The risks associated with antipsychotic medications were acknowledged, alongside the benefits of non-pharmacological strategies. A call for further research into diagnostic criteria and long-term outcomes was made, with a focus on improving patient care and reducing psychosis-related complications in hospital settings.