Blog Posts


Documentation Tip of the Week: Dementia

Posted on Wed, Aug 19, 2015
Documentation Tip of the Week: Dementia

Our weekly feature of documentation tips for clinicians.

By Timothy Brundage, MD

It is important when documenting dementia to state whether the mental status is consistent with the patient’s baseline or if it is an acute condition:

  • Acute Confusion or Acute Delirium on Chronic Dementia
  • Dementia with Behavioral Disturbance
  • Sundowning linked with Dementia
    • Are there changes in the patient’s mental status at night?
  • Metabolic Encephalopathy
    • Are the changes in mental status worsened by infection?
Altered Mental Status Acute Delirium; Sundowning Metabolic or Toxic Encephalopathy

SOI= Severity of Illness

Timothy Brundage, MD, is a hospitalist for EmCare at St. Petersburg General Hospital in St. Petersburg, Fla. Dr. Brundage earned his bachelor’s degree in chemistry and molecular biology at the University of Michigan, his medical degree at the Wayne State University School of Medicine and completed his residency in internal medicine at the University of South Florida College of Medicine. Subscribe to Dr. Brundage’s weekly documentation tips or ask him about specific documentation issues by emailing him at


Anesthesia Linked to Higher Risk of Dementia in Elderly

Posted on Wed, Jul 17, 2013
Anesthesia Linked to Higher Risk of Dementia in Elderly

General anesthesia increases risk 35 percent compared with no anesthesia

THURSDAY, June 6 (HealthDay News) -- Elderly people who have received general anesthesia are at a higher risk of developing dementia, according to a study presented at the annual Euroanaesthesia Congress, held from June 1 to 4 in Barcelona, Spain.

François Sztark, M.D., Ph.D., from the University of Bordeaux in France, and colleagues assessed 7,008 elderly non-demented community-dwelling French individuals (65 years and older) for dementia and a history of anesthesia over a follow-up period of eight years.

The researchers found that 32.9 percent of participants initially reported receiving anesthesia over the previous two years (19.0 percent general anesthesia, 13.5 percent local/locoregional anesthesia). By the end of end of the follow-up, 9.0 percent developed a dementia. Individuals who developed dementia significantly more commonly reported receiving anesthesia (37.0 versus 32.5 percent), which was entirely attributed to general anesthesia (22.3 versus 18.7 percent). After adjusting for various factors, having at least one general anesthesia significantly increased the risk of developing dementia compared with no anesthesia (relative risk, 1.35).

"These results are in favor of an increased risk for dementia several years after a general anesthesia," Sztark and colleagues conclude. "Recognition of postoperative cognitive dysfunction is essential in the perioperative management of elderly patients. A long-term follow-up of these patients should be planned."

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