The consequences of non-cognitive symptoms of dementia in medical hospital departments.
OBJECTIVE
To our knowledge, there are no studies investigating the non-cognitive symptoms of patients with dementia such as depression, agitation, or delusions among general hospital inpatients. The aim of this study was to investigate the frequency of such non-cognitive symptoms among medical inpatients and to analyze their impact on the length of hospital stay and on admission to nursing homes.


METHODS
The sample consisted of 372 elderly inpatients admitted to four internal medical departments (i.e., not including psychiatric wards) in Austria. Patients were investigated by research psychiatrists using the Clinical Interview Schedule. For the analyses of the non-cognitive symptomatology, only marked and severe symptoms were included. To identify predictors for the length of hospital stay and for nursing home placement, multivariate regression procedures were used.


RESULTS
Of all inpatients, 27.4% met criteria for dementia according to DSM-III-R. Of those with dementia, 27.8% had marked or severe non-cognitive symptoms. A diagnosis of dementia markedly increased the risk for nursing home referral and prolonged the duration of inpatient treatment. Among the demented, both, cognitive and non-cognitive symptoms turned out to be significant predictors for nursing home placement and for prolonged duration of acute hospital stay, even when controlling for other independent variables.


CONCLUSIONS
Non-cognitive symptoms occur frequently among medical inpatients with dementia and considerably increase both the duration of inpatient treatment and the risk of nursing home placement. Since such non-cognitive symptoms are treatable, they should receive attention from the hospital staff.
Wancata
Johannes
J
Department of Psychiatry, University of Vienna, Austria. johannes.wancata@akh-wien.ac.at
Windhaber
Johann
J
Krautgartner
Monika
M
Alexandrowicz
Rainer
R
D000368:Aged; D003702:Delusions / Q000453:epidemiology / Q000209:etiology*; D003704:Dementia / Q000175:diagnosis / Q000523:psychology*; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006748:Hospital Departments; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D015995:Prevalence; D011595:Psychomotor Agitation / Q000453:epidemiology / Q000209:etiology*