A prospective study was carried out in a general hospital in Reykjavík to evaluate the prevalence of delirium and dementia among 331 patients 70 years and older who were admitted as an emergency to the medical department. Cognitive function was screened with Mental Status Questionnaire (MSQ) and Mini-Mental State Examination (MMSE) and diagnosed according to DSM-III-R for delirium and dementia. Other information obtained included social and demographic factors, drug consumption, the main condition underlying the delirium and outcome. Severe cognitive dysfunction was present in 32% of all acutely admitted patients 70 years and older, which were diagnosed further as delirium 14% and dementia 18%. At follow-up, concurrent dementia was found in 70% of the delirium patients. The main causes for delirium were cardiac failure 27%, stroke 22% and sepsis 16% and the mortality rate was 32% compared with 8% in dementia alone. The prognosis of patients with delirium and dementia depends on detecting these disorders, and the clinical skills of physicians working with acutely ill elderly patients can be improved by relatively simple screening questionnaires such as the MSQ and MMSE.
Summary. Five glycoproteins have been measured in the blood of 145 diabetic patients with and without clinical evidence of complications. Patients with diabetic complications have higher glycoprotein levels particularly when expressed as a ratio to serum albumin levels. In 32 pairs of patients matched for age, sex, body weight, duration and treatment of diabetes, significantly higher haptoglobin, fibrinogen and caeruloplasmin levels were associated with the presence of diabetic complications, but blood glucose levels were not significantly different, fi-lipoprotein levels were positively correlated with age and a2-macroglobulin levels with the duration of clinical disease, but the type of antidiabetic therapy administered did not significantly alter glycoprotein levels. It is suggested that rising levels of certain glycoproteins in the blood of diabetic patients may indicate the development of diabetic vascular complications, but a prospective study is required before it can be decided whether this change predates the clinical appearance of the complications.
One hundred autopsy reports of persons who died in Iceland aged 90 years or over were studied and the causes of death were recorded. Another 100 autopsy reports of persons aged 70 years and under were used as controls. The disease pattern of those aged 70 or under did not differ much from that appearing in the Icelandic National Mortality Statistics, all ages included. However, in those aged 90 and over, the number of important diseases was higher and pneumonia, in particular, occurred more frequently both as an intervening and as an underlying cause of death. In the older age group, dementia was 3.4 times more common in males and 4.7 times more common in females. Malignant neoplasms were less frequent as causes of death in the older age group. In the older age group there was a much lower frequency of myocardial infarction compared with the controls, although the degree of arteriosclerosis did not differ in these two groups.
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