Common Medical Conditions that Might Affect Competence in the Elderly: The 4Ds (Depression, Delirium, Dementia, Drugs)

• Author: Dr. Nathan Herrmann
• Pages: 109-114

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Common Medical Conditions that

MightAectCompetenceintheElderly

THEDDEPRESSION DELIRIUM 

DEMENTIADRUGS

DrNathanHerrmannFRCPC*

The p urpose of this paper i s to high light common medical conditions

whichmighta ectcompetencein theolderindividual Thispaperw ill

beginby discussing somebasicconceptst hatwill helpalertlawyers to

situationsi nwhich the indexof suspicionfor incompetence shouldbe

raisedThisw illbefollowedbyadiscus sionofneuropsychiatricsymp-

tomsthatcaninterferewithcompetenceFinallyfourconditionsknown

asthe Dsdeliriumdepression dementiadrugswill behigh lighted

giventheirpropensitytoimpaircompetence



Perhapssurprisinglysimplyk nowingthe ageof apatient shouldhelp

lawyers determine whether there is any li kelihood of a medical con-

dition that may interfere with competence The WorldHealth Organ -

izationsGlobalBurdenof Diseasest udyaemptedto projectthe most

commonillness esthatw illaect populationsacross theglobeby

Theseconditions includecoronary arterydi seaseheart aackangi na

heartfa ilurecerebrovascular disease egst rokedepressioncancer

alcohol abuse and dementia Because all of these conditions become

morecommonwithagetheolderaclientthemoreconcernsthelawyer

* ProfessorDepartmentofPsyc hiatryFacultyofMedicineUnivers ityofToronto

HeadDivisionofGeriatr icPsychiatrySunnybrookHealt hSciencesCentreTo-

ronto.