Prevalence of dementia, delirium and psychiatric symptoms in various care settings for the elderly

Abstract

A prevalence study of psychiatric symptoms was performed in parts of a hospital catchment area in Mid-Sweden. In total 717 patients, aged 75 years and above, who were receiving care in an emergency hospital, three nursing homes, five old people's homes and two home medical care districts were included. All patients were examined using the OBS-scale (Organic Brain Syndrome Scale). Anxiety (51%), psychomotor slowing (45%), delirium (44%), depressed mood (41%), irritability (40%) and dementia (33%) were the most prevalent psychiatric symptoms or diagnoses in the sample but there were wide differences between the four care settings. The present study shows that the prevalence of dementia, delirium and psychiatric symptoms is high in all types of care settings for the elderly. It also demonstrates the need for psychiatric medical and nursing competence in all types of care for the elderly.

How well are the diagnosis and symptoms of dementia recorded in older patients admitted to hospital?

“…Dementia is prevalent in 42% of older people admitted to general hospital [3] though published prevalence figures range from 5-45% [3][4][5][6][7][8][9][10][11]. Patients with dementia often have difficulty communicating their needs, and in a hospital setting have a high prevalence of delirium (66%) [12], and psychological symptoms in the absence of delirium (depression (34%), anxiety (35%), delusions (11%) and hallucinations (15%)) [13].…”

“…Previous attempts to describe dementia prevalence, and the symptoms associated with it, in a general hospital setting have involved prospective objective memory screening, and subsequent clinical assessment [3][4][5][6][7][8][9][10][11][12][13]17]. The rigorous screening methods these studies employ may give an accurate account of the hospital prevalence but they potentially overestimate the actual clinical record, that is, the number of patients with a pre-existing diagnosis of dementia identified as such during their hospital stay and the number of symptoms recorded.…”

The Organic Brain Syndrome (OBS) scale: a systematic review

“…The conformity of the scale with the criteria stated in DSM-III, DSM-III-R and DSM-IV (APA, 1980;1987;1994) have been supported by several studies (Berggren et al, 1987;Sandberg et al, 1998;Andersson et al, 2001). The tests and crossevaluations carried out in these studies strongly confirm the reliability of the diagnosis Article for submiss.…”

“…A study focusing upon a single item 'depressed mood' in the OBS 2 scale showed strong correlations with the Montgomery-Åsberg Depression Rating Scale (MADRS) (Montgomery and Åsberg, 1979) and The Clinical Global Impression (CGI) Scale (Guy, 1976) (MADRS: r s 0.85, CGI scale: r s 0.88) (Sandberg et al, 1998) (Table 1 and 2).…”

Assessing and Managing Delirium in Surgical and Internal Medicine: an Overview

“…Başka birçok tıbbi durumun da eşlik edebildiği son dönem kanser hastaları üzerinde prospektif olarak yapılan bir çalışmada %32 oranında deliryum gelişmiştir (10). Bakım evlerinde tedavi gören 75 yaşın üzerindeki 717 hastada yapı-lan bir çalışmada, hastalarda deliryum %43,9 ve deliryumla demans birlikteliği %18,8 oranlarında bulunmuştur (11). Geriatri servisinde yatan 225 hasta üzerinde yapılan başka bir çalışmada ise hastaların %18'inin yatış sırasında deliryum tanısı aldığı ve %24'ünde ise yatış sırasında deliryum geliştiği kaydedilmiştir (12).…”