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P3‐003: Comorbidity, functional and nutritional status in demented and non‐demented patients stratified by age
Author(s) -
Bellelli Giuseppe,
Morghen Sara,
Trabucchi Marco
Publication year - 2008
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2008.05.1566
Subject(s) - medicine , dementia , comorbidity , body mass index , gerontology , demographics , pediatrics , disease , demography , sociology
registers during the last six months of 2003. Through medical record review, we evaluated the completeness of the work-up on which the dementia diagnosis was based, using national and international evidencebased dementia guidelines as reference standards. Furthermore, based on the quality of the clinical information in the medical records and the clinical assessment of the patients who were alive at the time of the study and agreed to participate, we determined whether dementia diagnoses could be confirmed according to clinical diagnostic criteria for dementia. Results: The patients were from 45 hospitals located in 15 counties representing all hospital capture areas in Denmark. Medical records from 197 patients were reviewed and 51 patients were interviewed. According to the medical records, 89 (45.2%) were diagnosed with dementia without specification, 68 (34.5%) with Alzheimer’s disease (AD) and 29 (14.7%) with vascular dementia (VaD). A complete dementia work-up was done in only 39.6% of the patients and only 20.2% of those with incomplete work-up had documented referral to follow-up. Dementia syndrome was confirmed in 88.5%. AD was confirmed in 86.8%, but 30 AD cases were misclassified as dementia without specification and other subtypes. VaD was confirmed in only 20.7%. Conclusions: The adherence to clinical guidelines concerning dementia work-up is inadequate in the secondary health care sector. Although the clinical diagnosis of dementia as well as AD has a good validity, too many patients are not diagnosed with a correct subtype and AD is significantly underdiagnosed. Consequently, many patients with dementia today may not receive appropriate treatment and care.