brain, spinal cord, and nerve disorders
Stupor and Coma
Essentials for Older People: Coma and Stupor
Impaired consciousness, including lethargy, stupor, and coma, is a particular concern among older people for the following reasons: Brain and Nervous System : Changes in other parts of the body also make older people more sensitive to the Benefits and Risks of Prescription Drugs . For example, as people age, the kidneys are less able to excrete drugs into urine, and the liver is less able to break down (metabolize) many drugs. Thus, drugs are less readily removed from the body. More of the drug may remain in the blood and may remain there longer. More of the drug may then reach the brain and affect brain function. As a result, even a low dose of a drug can make older people feel confused or drowsy. Often, older people need a lower dose than is typically used. Many older people take several drugs (called polypharmacy) because they have one or more chronic disorders such as high blood pressure, diabetes, or arthritis. Taking several drugs increases the risk of Drug Interactions , possibly negatively affecting the brain. For example, one drug may cause the level of another drug to increase. A complex drug schedule:Also, if older people have to take many drugs, the schedule for taking them may be complex. As a result, they are more likely to make mistakes and may take too much or too little of a drug. Effect of minor disorders:Relatively minor disorders, such as a urinary tract infection or dehydration, are more likely to impair consciousness in older people than in younger people. Presence of other disorders:Many disorders that are more common among older people can impair consciousness. They include strokes, brain tumors, bulges in weakened arteries (aneurysms) in the brain, metabolic disorders, severe lung disorders, severe infections, and heart failure. Other disorders (such as diabetes) increase the risk of impaired consciousness if another problem (such as dehydration or an infection) develops. Older people are at higher risk of Overview of Head Injuries after a Lifetime exposure to toxins:Over a lifetime, exposure to toxins in foods and the environment can damage brain cells and increase the risk of consciousness becoming impaired. Difficulty recognizing impaired consciousness:Impaired consciousness may be harder to recognize in older people. If older people become less alert or less conscious of things around them, family members and friends may not notice or may assume that the change results from aging. (Impaired consciousness is not a normal part of aging.) Also, a change in consciousness may be harder to discern in older people who have dementia or another brain disorder or who have had a stroke. Ability to recover:Older people are less likely to recover from stupor or coma because the brain becomes less able to repair itself as people age. In older people, consciousness is commonly impaired by reactions to drugs, dehydration, and infections. 