The demented elderly in the city of Helsinki: functional capacity and placement.

OBJECTIVE

To study prevalence, functional capacity, and placement of demented patients in a randomly selected population.

DESIGN

Survey.

SETTING

Random sample from population registry of the City of Helsinki.

PARTICIPANTS

Nine hundred subjects aged 75 years, 80 years and 85-years, 300 in each group.

MEASUREMENTS

For each participant, we completed a questionnaire for the subject and an informant and a functional-capacity scale and Mini-Mental Status Examination by a community nurse, including the Clinical Dementia Rating (CDR) scale. Subjects with CDR of 0.5 or greater were examined by a neurologist who diagnosed the presence or absence of dementia according to DSM-III-R.

RESULTS

Ninety-three subjects of the 656 whose CDR was known were found to have dementia. Three-quarters of them lived in institutions, and they comprised 33%, 60%, and 68% of all institutionalized patients in the above-mentioned age groups, respectively. Community residents suffering from dementia often lived with a caring relative and needed many services. A considerable part of the need was not met.

CONCLUSIONS

In the older age groups, the need for institutional placement due to dementia is great. According to our study, it seems unlikely that these patients could be cared for in any other way, at least not on a large scale. The need for services for home-dwelling patients is also great, and the relatives carry a heavy load in taking care of demented patients.