[Diagnostic procedures and frequency of dementia. A prospective study in the daily routine of a geriatric hospital (PAOLA study)].
All 1019 patients admitted to the department of geriatric medicine of a general hospital were screened during an 11-month period prospectively and consecutively for dementia. This investigation is part of a study for investigation of informal caregivers and their willingness for home caregiving of dementia patients (PAOLA study). In about half of the 1019 patients, there was a suspicion of dementia by a median age of 83 years. In 28.2% (n=287) of all cases, dementia was clinically diagnosed and in 60.9% (n=621) it could be clinically ruled out at the time of investigation. Underlying diseases which initially misled to dementia suspicion were in 26.8% (n=30) of these cases depression disorders, 13.4% (n=15) intracranial lesions including tumor and hemorrhage, 8.9% (n=10) other psychiatric diseases including substance abuse as well as disabilities in seeing and hearing. These differential diagnoses might be treatable in individual cases. This study could not clarify in 10.9% (n=111) of all cases whether dementia was present in a patient at the time studied. It was mainly limited due to multiple concomitant morbidities and reduced patient communication skills.We recommend that structured diagnostic procedures and treatments should be performed at specialized centers in order to avoid missing any treatable underlying diseases. In addition, the patients should be followed up at regular intervals.
Trauschke
T
T
Institut für Medizinische Soziologie, Universitätsklinikum der Johann-Wolfgang-Goethe-Universität, Theodor-Stern-Kai 7, Frankfurt am Main, Germany. trauschke@em.uni-frankfurt.de
Werner
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H
Gerlinger
T
T
D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D005858:Germany / Q000453:epidemiology; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity