Unrecognized dementia in elderly patients admitted to hospital with psychiatric symptoms.
In this study, we hypothesized that elderly patients with first admission to a psychiatric hospital commonly suffer from dementia but did not have such a diagnosis on admission. Over a period of 5 years, we surveyed all medical journals from patients treated for the first time at the Department of Psychogeriatrics. By selecting all inpatients treated at the only regional psychiatric hospital within a defined geographic area, the selected patients became representative of this geographic area. After a diagnostic work-up at the hospital, 72 of 239 patients satisfied clinical criteria of dementia. Of these patients, 7 had Alzheimer's disease and 7 had evidence of vascular dementia. We identified 51 of 72 patients (71%) with an endpoint diagnosis of dementia made at the hospital without any clinical information suggesting dementia at the time of hospitalization. Nonspecific psychosis (35%), depression (15%), and behavioral disturbances (8%) represented the most common diagnoses proposed by the referring doctor. In conclusion, dementia may be a difficult diagnosis in elderly patients with psychiatric symptoms. This study reminds clinicians that dementia should be considered in these patients.
Department of Neurology, University Hospital of Tromsø, Norway.
S I
SI
Bekkelund
I
I
Kujala
B
B
Rosenvinge
D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D015140:Dementia, Vascular / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D007297:Inpatients / Q000523:psychology / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis; D009664:Norway / Q000453:epidemiology; D012189:Retrospective Studies; D017678:Sex Distribution