The GDS does not show a better criterion validity than the CES-D, but methodological limitations of primary studies hamper the generalizability of pooled analyses.

Background: A variety of interventions are available to support the caregivers of dementia patients. For the purposes of service planning, we developed an instrument to assess the needs of these caregivers and to determine whether needs are met. The reliability and validity of this new instrument was also investigated.Methods: The development of the Carers' Needs Assessment for Dementia (CNA-D), was based on in-depth interviews and a focus group. The combined inter-rater and test–retest reliability was investigated among 45 dementia caregivers. Correlations of the CNA-D with the Zarit Burden Inventory were used to analyze concurrent validity. Content validity was investigated by performing a separate survey among 40 caregivers and 40 professionals.Results: The CNA-D is a semi-structured research interview including 18 problem areas. For each problem area, the CNA-D offers several possible interventions. The relevance of the problem areas and the interventions (content validity) was confirmed by most of the study participants. Significant positive associations were found between the total score of the Zarit Burden Inventory and the number of problems and the number of unmet needs according to the CNA-D. The agreement between the interviewers was “excellent” (κ above 0.75) in 73.7% of the problem areas and in 69.9% of the interventions.Conclusions: The CNA-D is a valid and reliable instrument for comprehensively assessing the needs of dementia caregivers.

Several authors have pointed out that in the next few decades dementia will affect a considerably increasing number of the elderly. To our knowledge there exist no calculations of the number of demented persons for the whole European region. We made calculations on the number of dementia cases for the period 2000-2050 based on the population projections of the United Nations. For this purpose, we used the results of several meta-analyses of epidemiological studies. The number of prevalent dementia cases in the year 2000 was 7.1 million. Within the next 50 years, this number will rise to about 16.2 million dementia sufferers. The number of new dementia cases per year will increase from about 1.9 million in the year 2000 to about 4.1 million in the year 2050. Contrarily, the working-age population will considerably decrease during the next 50 years. In the year 2000, 7.1 million dementia cases faced 493 million persons in working-age. This equals a ratio of 69.4 persons in working-age per one demented person. Until the year 2050, this ratio will decrease to only 21.1. Thus, the financial and emotional burden placed by dementia on the working-age population will markedly rise.

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Non-cognitive symptoms occur frequently among medical inpatients with dementia and considerably increase both the duration of inpatient treatment and the risk of nursing home placement. Since such non-cognitive symptoms are treatable, they should receive attention from the hospital staff.