1995 Fiscal Year Final Research Report Summary
An Physiological Survey on the Mechanism of Delirium in the Elderly
| Project/Area Number |
06670963
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Psychiatric science
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| Research Institution | Tottori University |
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Principal Investigator |
INOUE Yuichi Faculty of Medicine, Tottori University, Department of Neuropsychiatry, Assistant Professer, 医学部・附属病院, 講師 (50213179)
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| Co-Investigator(Kenkyū-buntansha) |
NAKAMURA Junichi Faculty of Medicine, Tottori University, Department of Neuropsychiatry, Research, 医学部・附属病院, 助手 (90237404)
KISHIMOTO Akira Faculty of Medicine, Tottori University, Department of Neuropsychiatry, Assistan, 医学部・附属病院, 講師 (00093584)
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| Project Period (FY) |
1994 – 1995
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| Keywords | Postoperative dilirium / REM sleep / sleep - awake rhythm / methylcobalamin / hypoactive delirium / elderly |
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| Research Abstract |
We made a single blind controlled study on the treatment of postoperative delirium in the elderly with intravenous administration of Vitamin B_<12> (methylcobalamin), a strong regulator of sleep - awake rhythm and placebo for 14 consecutive days, and assessed the mechanism of the disorder from the aspect of biological rhythm. In the group administered with methylcobalamin (n=10), periods from the start of the administration to the remission of delirium were significantly shorter than the group with placebo (n=10). From 3rd day to 7th day after the initiation of the administration, sum of the points of delirium rating scale (DRS) were lower in the group with methylcobalamin compared with the group with placebo. The periods, in which the symptom items of DRS such as emotional instabilty, diurnal varition of the mood, disorder of sleep - awake rhythm and hallucination existed, were significantly shorter in the group with methylcobalamin than the group with placebo. When analyzing the diurnal distribution of sleep, daytime sleep to night time sleep ratio were significantly smaller from 3rd day to 9th day in the group with methylcobalamin. In addition to that, hypersomnolence which existed in two or three days period befor the remission of postoperative delirium were suppressed in the group with methylcobalamin.
Judging from the relation between the course of clinical symptoms and sleep-awake rhythm as well as the efficacy of methylcobalamin, postoperative delirium in the elderly was suspected to occur as a result of the circadian rhythm disorder. And also, methylcobalamin was thought to increase nocturnal sleep and/ or enhance the alertness in the daytime leading to stabilize sleep - awake rhythm.
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