Unrecognized dementia in elderly patients admitted to hospital with psychiatric symptoms

J Geriatr Psychiatry Neurol. 2001 Spring;14(1):7-10. doi: 10.1177/089198870101400103.

Abstract

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.

MeSH terms

  • Activities of Daily Living / psychology*
  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / diagnosis
  • Dementia / diagnosis*
  • Dementia / epidemiology
  • Dementia / psychology
  • Dementia, Vascular / diagnosis
  • Diagnosis, Differential
  • Female
  • Hospitals, Psychiatric*
  • Humans
  • Inpatients / psychology
  • Inpatients / statistics & numerical data*
  • Male
  • Mental Disorders / diagnosis
  • Norway / epidemiology
  • Retrospective Studies
  • Sex Distribution