New diagnoses of dementia among older patients admitted to postacute care.

Détails

ID Serval
serval:BIB_DFFF033C8AD0
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
New diagnoses of dementia among older patients admitted to postacute care.
Périodique
Journal of the American Medical Directors Association
Auteur⸱e⸱s
Ferretti Michele, Seematter-Bagnoud Laurence, Martin Estelle, Büla Christophe J.
ISSN
1538-9375[electronic], 1525-8610[linking]
Statut éditorial
Publié
Date de publication
2010
Peer-reviewed
Oui
Volume
11
Numéro
5
Pages
371-376
Langue
anglais
Résumé
Objectives: To determine the prevalence of dementia and the proportion of undiagnosed dementia in elderly patients admitted to postacute care, and to identify patients' characteristics associated with undiagnosed dementia.
Design: Cross-sectional study.
Setting: Academic postacute rehabilitation facility in Lausanne, Switzerland.
Participants: Patients (N = 1764) aged 70 years and older.
Measurements: Data on socio-demographic, medical, functional, and affective status were collected upon admission. Data on cognitive performance (Mini-Mental State Exam [MMSE]), and cognition-related discharge diagnoses were abstracted through a structured review of discharge summaries.
Results: Overall, 24.1% (425/1764) patients had a diagnosis of dementia, most frequently secondary to Alzheimer's disease (260/425, 61.2%). Among dementia cases, 70.8% (301/425) were newly diagnosed during postacute stay. This proportion was lower among patients referred from internal medicine than from orthopedic/surgery services (65.8% versus 74.8%, P = .042). Compared to patients with already diagnosed dementia, those newly diagnosed were older, lived alone more frequently, and had better functional status and MMSE score at admission (all P < .05). In multivariate analysis, previously undetected dementia remained associated with older age (OR = 2.4 for age 85 years and older, 95% CI 1.5-4.0, P = .001) and normal MMSE at admission (OR = 5.9, 95% CI 2.7-12.7, P < .001).
Conclusion: Dementia was present in almost a fourth of elderly patients referred to postacute care, but was diagnosed in less than a third before admission. Oldest old patients appear especially at risk for underrecognition. These results emphasize the high diagnostic yield of systematic cognitive assessment in the postacute care setting to improve these patients' management and quality of life.
Mots-clé
Elderly, Postacute Care, Dementia, Detection, Assisted Living Facilities, Services-Task-Force, Cognitive Impairment, Alzheimers-Disease, Prevalence, Health, Documentation, Recognition, Performance, Residents
Pubmed
Web of science
Open Access
Oui
Création de la notice
12/07/2010 15:04
Dernière modification de la notice
20/08/2019 16:04
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