title: Dementia in older people admitted to hospital: a regional multi-hospital observational study of prevalence, associations and case recognition.
abstract: BACKGROUND
  Previous studies have indicated a prevalence of dementia in older admissions of ∼42% in a single London teaching hospital, and 21% in four Queensland hospitals. However, there is a lack of published data from any European country on the prevalence of dementia across hospitals and between patient groups.
  
  
  OBJECTIVE
  To determine the prevalence and associations of dementia in older patients admitted to acute hospitals in Ireland.
  
  
  METHODS
  Six hundred and six patients aged ≥70 years were recruited on admission to six hospitals in Cork County. Screening consisted of Standardised Mini-Mental State Examination (SMMSE); patients with scores <27/30 had further assessment with the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Final expert diagnosis was based on SMMSE, IQCODE and relevant medical and demographic history. Patients were screened for delirium and depression, and assessed for co-morbidity, functional ability and nutritional status.
  
  
  RESULTS
  Of 598 older patients admitted to acute hospitals, 25% overall had dementia; with 29% in public hospitals. Prevalence varied between hospitals (P < 0.001); most common in rural hospitals and acute medical admissions. Only 35.6% of patients with dementia had a previous diagnosis. Patients with dementia were older and frailer, with higher co-morbidity, malnutrition and lower functional status (P < 0.001). Delirium was commonly superimposed on dementia (57%) on admission.
  
  
  CONCLUSIONS
  Dementia is common in older people admitted to acute hospitals, particularly in acute medical admissions, and rural hospitals, where services may be less available. Most dementia is not previously diagnosed, emphasising the necessity for cognitive assessment in older people on presentation to hospital.
authors.affiliation: Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Timmons
authors.affiliation: Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland.
authors.forename: Edmund
authors.initials: E
authors.lastname: Manning
authors.affiliation: Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland.
authors.forename: Aoife
authors.initials: A
authors.lastname: Barrett
authors.affiliation: Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland.
authors.forename: Noeleen M
authors.initials: NM
authors.lastname: Brady
authors.affiliation: Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Browne
authors.affiliation: Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland.
authors.forename: Emma
authors.initials: E
authors.lastname: O'Shea
authors.affiliation: Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland.
authors.forename: David William
authors.initials: DW
authors.lastname: Molloy
authors.affiliation: Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland.
authors.forename: Niamh A
authors.initials: NA
authors.lastname: O'Regan
authors.affiliation: School of Psychology, Deakin University, Melbourne, VIC, Australia.
authors.forename: Steven
authors.initials: S
authors.lastname: Trawley
authors.affiliation: The Dementia Services Information and Development Centre, St James's Hospital, Dublin, Ireland School of Social Work and Social Policy, Trinity College Dublin, Dublin, Ireland.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Cahill
authors.affiliation: School of Mathematical Sciences, University College Cork, Cork, Ireland.
authors.forename: Kathleen
authors.initials: K
authors.lastname: O'Sullivan
authors.affiliation: Centre for Policy Studies, University College Cork, Cork, Ireland.
authors.forename: Noel
authors.initials: N
authors.lastname: Woods
authors.affiliation: Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
authors.forename: David
authors.initials: D
authors.lastname: Meagher
authors.affiliation: South Lee Mental Health Service, Health Services Executive, Cork University Hospital, Cork, Ireland Department of Psychiatry, University College Cork, Cork, Ireland.
authors.forename: Aoife M
authors.initials: AM
authors.lastname: Ni Chorcorain
authors.affiliation: Services for Older People, Social Care, Health Services Executive, Cork, Ireland.
authors.forename: John G
authors.initials: JG
authors.lastname: Linehan
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D009483:Neuropsychological Tests; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: acute hospital; awareness; cognitive impairment; dementia; older people; screening