title: [First year prognosis of patients hospitalized in an acute geriatric ward with a known dementia or newly diagnosed].
abstract: In France, only a third of demented patients have an established diagnostic of dementia. Hospitalization is often an opportunity to perform a diagnostic of dementia. Real benefits for patients of such a diagnostic process are unknown. The objective of the study was to observe prognosis of elderly patients hospitalized in geriatric courses in terms of mortality, hospitalization rate and entry into an institution. This was a monocentric prospective study with a one-year follow-up of 90 patients hospitalized in an acute geriatric ward with either dementia known by general practitioner, either diagnosed during the hospitalization according to DSM IV criteria. A one year follow-up by phone has been conducted. From a consecutive set of 159 inpatients for 18 weeks, we included in this study 49 patients with a known dementia (group 1, mean age 85.7±4.6 years, mean Mini-mental state examination (MMSE) score 12.4±6.2) and 41 patients with dementia diagnosed during hospitalization (group 2, mean age 88.4±6.4 years, mean MMSE score 16.1±6.5). Differences between the two groups were significant for age (p<0.03) and MMSE score (p<0.02). One-year mortality rate was near 30% in the 2 groups. Rate of institutionalization was 33% in group 1 and 49% in group 2 (not statistically significant). There was a significant difference in number of days spent at home between group 1 and group 2, respectively 190.9±159.9 days vs 111.1±148.1 days (p<0.03). Demented patients previously diagnosed lived longer at home at one year than patients newly diagnosed. These results tend to support the diagnosis of dementia in very elderly patients with multiple comorbidities. Conditions of living at home, in particular the quality of life, should be the object of further studies.
authors.affiliation: Service de médecine gériatrique, Hôpital Sainte-Périne, AP-HP, Paris, France.
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Vétillard
authors.forename: Laetitia
authors.initials: L
authors.lastname: Grandcollot
authors.forename: Laurent
authors.initials: L
authors.lastname: Lechowski
authors.forename: Marine
authors.initials: M
authors.lastname: Le Crane
authors.forename: Bertrand
authors.initials: B
authors.lastname: Denis
authors.forename: Lucie
authors.initials: L
authors.lastname: Aubert
authors.forename: Sophie
authors.initials: S
authors.lastname: Van Pradelles
authors.forename: Florence
authors.initials: F
authors.lastname: Muller de Schongor
authors.forename: Zina
authors.initials: Z
authors.lastname: Seridi
authors.forename: Danièle
authors.initials: D
authors.lastname: Tortrat
authors.forename: Laurent
authors.initials: L
authors.lastname: Teillet
mesh_terms: D003704:Dementia / Q000175:diagnosis; D006801:Humans; D007326:Institutionalization; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life
keywords: dementia; elderly; hospitalization