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老年病房患者的痴呆诊断和治疗:波兰的一项横断面研究。

Dementia Diagnoses and Treatment in Geriatric Ward Patients: A Cross-Sectional Study in Poland.

机构信息

Department of Geriatrics, Medical University of Bialystok, Bialystok, Poland.

Department of Geriatrics, Hospital of the Ministry of Interior in Bialystok, Bialystok, Poland.

出版信息

Clin Interv Aging. 2020 Nov 13;15:2183-2194. doi: 10.2147/CIA.S281723. eCollection 2020.

Abstract

PURPOSE

The study aimed to determine the prevalence of dementia, its types, and treatment in geriatric ward patients.

PATIENTS AND METHODS

A cross-sectional study of 406 patients (77.8% women, median age 82, IQR (77-86) years) who underwent a comprehensive geriatric assessment in one of the Polish hospitals between September 2014 and April 2015 was conducted.

RESULTS

Dementia was diagnosed in 132 (32.5%) patients (46% mixed dementia; 32% Alzheimer's disease; 10%vascular dementia; 5% dementia in Parkinson's disease; 4% frontotemporal; 3% atypical parkinsonism). A total of 95 (72%) dementia cases were not detected before, and in the above half of these patients, it was not mentioned in the referral document. Only 33.3% of dementia patients were on cognitive enhancers (donepezil, rivastigmine, or memantine); 36.4% received antipsychotics, 45.5% received anti-depressants, 25.8% received nootropics, and 16.7% received anxiolytics/hypnotics.

DISCUSSION

The results confirmed the high incidence of underdiagnoses and undertreatment of dementia in patients admitted to the geriatric ward. It is partly due to the lack of systematic cognitive assessment in primary care settings, although other factors can play a role.

摘要

目的

本研究旨在确定老年病房患者中痴呆的患病率、类型和治疗情况。

患者和方法

这是一项横断面研究,共纳入 406 名患者(77.8%为女性,中位年龄 82 岁,IQR(77-86)岁),他们于 2014 年 9 月至 2015 年 4 月期间在波兰的一家医院接受了全面的老年评估。

结果

在 132 名(32.5%)患者中诊断出痴呆(46%为混合性痴呆;32%为阿尔茨海默病;10%为血管性痴呆;5%为帕金森病性痴呆;4%为额颞叶痴呆;3%为非典型帕金森病)。共有 95 例(72%)痴呆病例此前未被发现,在上述患者的一半以上中,转诊文件中并未提及。仅有 33.3%的痴呆患者使用认知增强剂(多奈哌齐、利斯的明或美金刚);36.4%使用抗精神病药物,36.4%使用抗抑郁药,45.5%使用抗抑郁药,25.8%使用益智药,16.7%使用抗焦虑药/催眠药。

讨论

研究结果证实,在入住老年病房的患者中,痴呆的漏诊和治疗不足的情况发生率很高。这部分是由于初级保健环境中缺乏系统的认知评估,但其他因素也可能发挥作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5565/7671484/1ec6a737831e/CIA-15-2183-g0001.jpg

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