Timmons Suzanne, Manning Edmund, Barrett Aoife, Brady Noeleen M, Browne Vanessa, O'Shea Emma, Molloy David William, O'Regan Niamh A, Trawley Steven, Cahill Suzanne, O'Sullivan Kathleen, Woods Noel, Meagher David, Ni Chorcorain Aoife M, Linehan John G
Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland.
School of Psychology, Deakin University, Melbourne, VIC, Australia.
Age Ageing. 2015 Nov;44(6):993-9. doi: 10.1093/ageing/afv131. Epub 2015 Sep 28.
Previous studies have indicated a prevalence of dementia in older admissions of ∼42% in a single London teaching hospital, and 21% in four Queensland hospitals. However, there is a lack of published data from any European country on the prevalence of dementia across hospitals and between patient groups.
To determine the prevalence and associations of dementia in older patients admitted to acute hospitals in Ireland.
Six hundred and six patients aged ≥70 years were recruited on admission to six hospitals in Cork County. Screening consisted of Standardised Mini-Mental State Examination (SMMSE); patients with scores <27/30 had further assessment with the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Final expert diagnosis was based on SMMSE, IQCODE and relevant medical and demographic history. Patients were screened for delirium and depression, and assessed for co-morbidity, functional ability and nutritional status.
Of 598 older patients admitted to acute hospitals, 25% overall had dementia; with 29% in public hospitals. Prevalence varied between hospitals (P < 0.001); most common in rural hospitals and acute medical admissions. Only 35.6% of patients with dementia had a previous diagnosis. Patients with dementia were older and frailer, with higher co-morbidity, malnutrition and lower functional status (P < 0.001). Delirium was commonly superimposed on dementia (57%) on admission.
Dementia is common in older people admitted to acute hospitals, particularly in acute medical admissions, and rural hospitals, where services may be less available. Most dementia is not previously diagnosed, emphasising the necessity for cognitive assessment in older people on presentation to hospital.
先前的研究表明，在伦敦一家教学医院的老年住院患者中，痴呆症患病率约为42%，在昆士兰的四家医院中为21%。然而，尚无来自任何欧洲国家关于各医院及不同患者群体中痴呆症患病率的公开数据。
确定爱尔兰急症医院老年患者中痴呆症的患病率及相关因素。
招募了科克郡六家医院606名年龄≥70岁的入院患者。筛查采用标准化简易精神状态检查表（SMMSE）；得分<27/30的患者需通过老年人认知能力下降知情者问卷（IQCODE）进行进一步评估。最终的专家诊断基于SMMSE、IQCODE以及相关的医疗和人口统计学病史。对患者进行谵妄和抑郁筛查，并评估其合并症、功能能力和营养状况。
在598名入住急症医院的老年患者中，总体痴呆症患病率为25%；公立医院为29%。各医院患病率存在差异（P<0.001）；在农村医院和急性内科入院患者中最为常见。仅有35.6%的痴呆症患者此前已被诊断。痴呆症患者年龄更大、身体更虚弱，合并症更多、营养不良且功能状态更低（P<0.001）。入院时谵妄常叠加在痴呆症之上（57%）。
痴呆症在入住急症医院的老年人中很常见，尤其是在急性内科入院患者以及医疗服务可能较少的农村医院。大多数痴呆症此前未被诊断出来，这凸显了老年人入院时进行认知评估的必要性。
