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Dementia Among Medical Inpatients: Evaluation of 2000 Consecutive Admissions

Dementia Among Medical Inpatients: Evaluation of 2000 Consecutive Admissions Abstract • Two thousand consecutive patients aged 55 years and older admitted to a department of medicine in a large university hospital were examined for the presence of dementia. The occurrence of moderate and severe dementia was 9.1% for all age groups. It increased from 0.8% in the age group from 55 to 64 years to 31.2% in patients aged 85 years and older. Of the demented patients, 41.4% were delirious at admission, and 24.9% of all delirious patients were demented. Patients with vascular dementia constituted 72.4%, those with primary degenerative dementia 23.0%, and those with specific causes 4.6% of all demented patients. The mean hospitalization time for demented patients was significantly longer, and they needed significantly more daily nursing care, when compared with nondemented patients. (Arch Intern Med 1986;146:1923-1926) References 1. Kay DWK, Beamish P, Roth M: Old age mental disorders in Newcastle upon Tyne: I. A study of prevalence. Br J Psychiatry 1964;110:146-158.Crossref 2. Kay DWK, Bergmann K, Foster EM, et al: Mental illness and hospital usage in the elderly: A random sample followed up. Compr Psychiatry 1970;11:26-35.Crossref 3. Sulkava R, Wikström J, Aromaa A, et al: Prevalence of severe dementia in Finland. Neurology 1985;35:1025-1029.Crossref 4. Adolfsson R, Gottfries CG, Nyström L, et al: Prevalence of dementia disorders in institutionalized Swedish old people: The work load imposed by caring for these patients. Acta Psychiatr Scand 1981;63:225-244.Crossref 5. Maguire GP, Julier DL, Hawton KE, et al: Psychiatric morbidity and referral on two general medical wards. Br Med J 1974;1:260-270.Crossref 6. Haglund RMJ, Schuckit MA: A clinical comparison of tests of organicity in elderly patients. J Gerontol 1976;31:654-659.Crossref 7. Jacobs JW, Bernhard MR, Delgado A, et al: Screening for organic mental syndromes in the medically ill. Ann Intern Med 1977;86:40-46.Crossref 8. Knights EB, Folstein MF: Unsuspected emotional and cognitive disturbance in medical patients. Ann Intern Med 1977;87:723-724.Crossref 9. Anthony JC, LeResche L, Niaz U, et al: Limits of the 'Mini-Mental State' as a screening test for dementia and delirium among hospital patients. Psychol Med 1982;12:397-408.Crossref 10. Bergmann K, Eastham EJ: Psychogeriatric ascertainment and assessment for treatment in an acute medical ward setting. Age Ageing 1974;3:174-188.Crossref 11. Roca RP, Klein LE, Kirby SM, et al: Recognition of dementia among medical patients. Arch Intern Med 1984;144:73-75.Crossref 12. Pfeiffer E: A Short Portable Mental Status Questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc 1975;23:433-441. 13. Smyer MA, Hofland BF, Jonas EA: Validity study of the Short Portable Mental Status Questionnaire for the elderly. J Am Geriatr Soc 1979;27:263-269. 14. Blessed G, Tomlinson BE, Roth M: The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. Br J Psychiatry 1968;114:797-811.Crossref 15. American Psychiatric Association Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders , ed 3. Washington, DC, American Psychiatric Association, 1980. 16. Royal College of Physicians Committee on Geriatrics: Organic mental impairment in the elderly: Implications for research, education and the provision of services. J R Coll Physicians Lond 1981;15:141-167. 17. Gurland B, Toner J: Differentiating dementia from nondementing conditions , in Mayeux R, Rosen WG (eds): The Dementias . New York, Raven Press, 1983, pp 1-17. 18. Lipowski ZJ: Transient cognitive disorders (delirium, acute confusional states) in the elderly. Am J Psychiatry 1983;140:1426-1436. 19. Roth M: The natural history of mental disorder in old age. J Ment Sci 1955;101:281-301. 20. Rosen WG, Terry RD, Fuld PA, et al: Pathological verification of ischemic score in differentiation of dementias. Ann Neurol 1980;7:486-488.Crossref 21. Dixon WJ, Brown MB, Engelman L, et al: BMDP Statistical Software 1981 . Los Angeles, University of California Press, 1985. 22. Rothman KJ, Boice JD: Epidemiologic Analysis With a Programmable Calculator , US Dept of Health, Education, and Welfare publication (NIH) 79-1649 Government Printing Office, 1979. 23. Sulkava R, Haltia M, Paetau A, et al: Accuracy of clinical diagnosis in primary degenerative dementia: Correlation with neuropathological findings. J Neurol Neurosurg Psychiatry 1983;46:9-13.Crossref 24. Brust JCM: Vascular dementia: Still overdiagnosed. Stroke 1983;14: 298-300.Crossref 25. Task Force Sponsored by the National Institute on Aging: Senility reconsidered: Treatment possibilities for mental impairment in the elderly. JAMA 1980;244:259-263.Crossref 26. Marsden CD, Harrison MJG: Outcome of investigation of patients with presenile dementia. Br Med J 1972;2:249-252.Crossref 27. Smith JS, Kiloh LG: The investigation of dementia: Results in 200 consecutive admissions. Lancet 1981;2:824-827.Crossref 28. Reifler BV, Larson E, Hanley R: Coexistence of cognitive impairment and depression in geriatric outpatients. Am J Psychiatry 1982;139:623-626. 29. Barclay LL, Zemcov A, Blass JP, et al: Survival in Alzheimer's disease and vascular dementias. Neurology 1985;35:834-840.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Dementia Among Medical Inpatients: Evaluation of 2000 Consecutive Admissions

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References (32)

Publisher
American Medical Association
Copyright
Copyright © 1986 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1986.00360220067013
Publisher site
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Abstract

Abstract • Two thousand consecutive patients aged 55 years and older admitted to a department of medicine in a large university hospital were examined for the presence of dementia. The occurrence of moderate and severe dementia was 9.1% for all age groups. It increased from 0.8% in the age group from 55 to 64 years to 31.2% in patients aged 85 years and older. Of the demented patients, 41.4% were delirious at admission, and 24.9% of all delirious patients were demented. Patients with vascular dementia constituted 72.4%, those with primary degenerative dementia 23.0%, and those with specific causes 4.6% of all demented patients. The mean hospitalization time for demented patients was significantly longer, and they needed significantly more daily nursing care, when compared with nondemented patients. (Arch Intern Med 1986;146:1923-1926) References 1. Kay DWK, Beamish P, Roth M: Old age mental disorders in Newcastle upon Tyne: I. A study of prevalence. Br J Psychiatry 1964;110:146-158.Crossref 2. Kay DWK, Bergmann K, Foster EM, et al: Mental illness and hospital usage in the elderly: A random sample followed up. Compr Psychiatry 1970;11:26-35.Crossref 3. Sulkava R, Wikström J, Aromaa A, et al: Prevalence of severe dementia in Finland. Neurology 1985;35:1025-1029.Crossref 4. Adolfsson R, Gottfries CG, Nyström L, et al: Prevalence of dementia disorders in institutionalized Swedish old people: The work load imposed by caring for these patients. Acta Psychiatr Scand 1981;63:225-244.Crossref 5. Maguire GP, Julier DL, Hawton KE, et al: Psychiatric morbidity and referral on two general medical wards. Br Med J 1974;1:260-270.Crossref 6. Haglund RMJ, Schuckit MA: A clinical comparison of tests of organicity in elderly patients. J Gerontol 1976;31:654-659.Crossref 7. Jacobs JW, Bernhard MR, Delgado A, et al: Screening for organic mental syndromes in the medically ill. Ann Intern Med 1977;86:40-46.Crossref 8. Knights EB, Folstein MF: Unsuspected emotional and cognitive disturbance in medical patients. Ann Intern Med 1977;87:723-724.Crossref 9. Anthony JC, LeResche L, Niaz U, et al: Limits of the 'Mini-Mental State' as a screening test for dementia and delirium among hospital patients. Psychol Med 1982;12:397-408.Crossref 10. Bergmann K, Eastham EJ: Psychogeriatric ascertainment and assessment for treatment in an acute medical ward setting. Age Ageing 1974;3:174-188.Crossref 11. Roca RP, Klein LE, Kirby SM, et al: Recognition of dementia among medical patients. Arch Intern Med 1984;144:73-75.Crossref 12. Pfeiffer E: A Short Portable Mental Status Questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc 1975;23:433-441. 13. Smyer MA, Hofland BF, Jonas EA: Validity study of the Short Portable Mental Status Questionnaire for the elderly. J Am Geriatr Soc 1979;27:263-269. 14. Blessed G, Tomlinson BE, Roth M: The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. Br J Psychiatry 1968;114:797-811.Crossref 15. American Psychiatric Association Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders , ed 3. Washington, DC, American Psychiatric Association, 1980. 16. Royal College of Physicians Committee on Geriatrics: Organic mental impairment in the elderly: Implications for research, education and the provision of services. J R Coll Physicians Lond 1981;15:141-167. 17. Gurland B, Toner J: Differentiating dementia from nondementing conditions , in Mayeux R, Rosen WG (eds): The Dementias . New York, Raven Press, 1983, pp 1-17. 18. Lipowski ZJ: Transient cognitive disorders (delirium, acute confusional states) in the elderly. Am J Psychiatry 1983;140:1426-1436. 19. Roth M: The natural history of mental disorder in old age. J Ment Sci 1955;101:281-301. 20. Rosen WG, Terry RD, Fuld PA, et al: Pathological verification of ischemic score in differentiation of dementias. Ann Neurol 1980;7:486-488.Crossref 21. Dixon WJ, Brown MB, Engelman L, et al: BMDP Statistical Software 1981 . Los Angeles, University of California Press, 1985. 22. Rothman KJ, Boice JD: Epidemiologic Analysis With a Programmable Calculator , US Dept of Health, Education, and Welfare publication (NIH) 79-1649 Government Printing Office, 1979. 23. Sulkava R, Haltia M, Paetau A, et al: Accuracy of clinical diagnosis in primary degenerative dementia: Correlation with neuropathological findings. J Neurol Neurosurg Psychiatry 1983;46:9-13.Crossref 24. Brust JCM: Vascular dementia: Still overdiagnosed. Stroke 1983;14: 298-300.Crossref 25. Task Force Sponsored by the National Institute on Aging: Senility reconsidered: Treatment possibilities for mental impairment in the elderly. JAMA 1980;244:259-263.Crossref 26. Marsden CD, Harrison MJG: Outcome of investigation of patients with presenile dementia. Br Med J 1972;2:249-252.Crossref 27. Smith JS, Kiloh LG: The investigation of dementia: Results in 200 consecutive admissions. Lancet 1981;2:824-827.Crossref 28. Reifler BV, Larson E, Hanley R: Coexistence of cognitive impairment and depression in geriatric outpatients. Am J Psychiatry 1982;139:623-626. 29. Barclay LL, Zemcov A, Blass JP, et al: Survival in Alzheimer's disease and vascular dementias. Neurology 1985;35:834-840.Crossref

Journal

Archives of Internal Medicine – American Medical Association

Published: Oct 1, 1986

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