Frequency of dementia among elderly admitted to a Geriatrics Inpatients Sector of a Brazilian public hospital

Thomazi, Rafael; Silveira, Liciana Vaz de Arruda; Boas, Paulo José Fortes Villas; Jacinto, Alessandro Ferrari

doi:10.1590/1980-57642018dn12-010005

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Dementia & Neuropsychologia

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Original Article • Dement. neuropsychol. 12 (1) • Jan-Mar 2018 • https://doi.org/10.1590/1980-57642018dn12-010005 copy

Frequency of dementia among elderly admitted to a Geriatrics Inpatients Sector of a Brazilian public hospital

FREQUÊNCIA DE DEMÊNCIA EM IDOSOS INTERNADOS EM ENFERMARIA DE GERIATRIA DE UM HOSPITAL PÚBLICO BRASILEIRO

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Patients with dementia are commonly admitted to inpatient sectors. The aim of this study was to describe the frequency of dementia among elderly inpatients admitted to the Geriatrics Sector of a Brazilian Tertiary University Hospital, and to identify associations between dementia and clinical and sociodemographic factors.

Methods:

All patients admitted to the Geriatrics Sector of a public Brazilian university-hospital from March 1^st 2014 to January 31^st 2015 were assessed by geriatricians. The patients were divided into groups "with or without diagnosis of dementia". Univariate analysis was performed between these two groups using the Chi-Square Test, Student's t-test or the Mann-Whitney Test.

Results:

One hundred and three elderly inpatients, with a mean age of 82 (±7.9) years, were assessed. Overall, 74.7% had low educational level (<4 years), 66% used polypharmacy, 57.2% developed delirium during hospitalization and 59% were totally dependent for basic activities of daily living. The diagnosis of dementia was observed in 59 (57%) subjects.

Conclusion:

The frequency of dementia was high among the elderly inpatients evaluated. The association between dementia and certain clinical conditions, such as incontinence, delirium and use of psychoactive drugs, was in line with the medical literature.

Key words:
aged; inpatient; dementia

		N	%
Gender	Male	60	58.2
Gender	Female	43	41.7
Marital status	Married	30	29
	Single	5	5
	Divorced	8	8
	Widowed	60	58
Race	Black and other	17	16.4
Race	White	86	83.6
Dwelling	Botucatu	89	86
Dwelling	Other	24	14
Education (years)	> 4	26	25.2
Education (years)	≤4	77	74.7
Polypharmacy (Four or more medications used)	Yes	68	66
Polypharmacy (Four or more medications used)	No	35	34
Psychotropic use	Antidepressants	35	34
	Neuroleptics	27	26
	Benzodiazepines	25	24
	Anticholinesterases	21	20
Dependency for activities of daily living	Independence	13	13
	Partial dependence	29	28
	Total dependence	61	59
Feeding	Tube feeding	23	33
Feeding	Oral feeding	80	77

	N	%
Hypertension	66	64
Dementia	59	57.2
Delirium	59	57.2
Pneumonia	44	42.7
ICU	16	15.5
Depression	37	35
Diabetes	34	33
Dyslipidemia	31	30
Falls in the last year	31	30
Urinary incontinence	44	42
Stroke	29	28
Heart Failure	30	29
Pressure lesion (admission)	44	42.7
Pressure injury (acquired)	35	34
CKD	17	16
Osteoarthrosis	48	46
Osteoporosis	26	25
Previous fractures	26	25
COPD	10	9
Deaths	35	34

	Dementia Mean ( ± SD)	Non-dementia Mean ( ± SD)	p
BMI	18.7 (16.8;21.4)	22.3 ( ± 4.9)	0.01^* * Student's t-test;
SAL	2.45 (2.1;3.0)^# # Median (Interquartile Range); SD: standard deviation; IQR: interquartile range; BMI: body mass index; SAL: serum albumin level.	2.9 ( ± 0.6)	0.01^ Mann-Whitney Test;

		Dementia		Non-dementia		P^* * Chi-Square test; HF: heart failure; COPD: chronic obstructive pulmonary disease; DBADL: dependency for basic activities of daily living; LTCI: long-term care institution.
		(N)	%	(N)	%
Psychoactive drug	Yes	45	76.2	19	43.1	0.001
Psychoactive drug	No	14	23.7	25	56.8	0.001
Neuroleptic	Yes	24	40.6	3	7.1	<0.001
Neuroleptic	No	35	59.3	39	92.8	<0.001
HF	Yes	11	18.6	19	43.1	0.007
HF	No	48	81.3	25	56.8	0.007
COPD	Yes	2	3.3	8	18.1	0.01
COPD	No	57	96.6	36	81.8	0.01
Incontinence	Yes	40	67.7	4	9	<0.001
Incontinence	No	19	32.2	40	90.9	<0.001
DBADL	Yes	48	81.3	13	29.5	<0.001
DBADL	No	11	18.6	31	70.4	<0.001
Delirium	Yes	41	69.4	18	40.9	0.004
Delirium	No	18	30.5	26	59	0.004
Pressure Lesion (admission)	Yes	33	55.9	11	25	0.002
Pressure Lesion (admission)	No	26	44	33	75	0.002
Pressure lesion (acquired)	Yes	27	45.7	8	18.1	0.003
Pressure lesion (acquired)	No	32	54.2	36	81.8	0.003
Caregiver	Yes	24	40.6	8	18.1	0.01
Caregiver	No	35	59.3	36	81.8	0.01
LTCI	Yes	17	28.8	5	11.3	0.03
LTCI	No	42	71.1	39	88.6	0.03
Bedridden	Yes	45	76.2	14	31.8	<0.001
Bedridden	No	14	23.7	30	68.1	<0.001

Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices, Torre Norte, São Paulo, SP, Brazil, CEP 04101-000, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br

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[1] Alessandro Ferrari Jacinto, Disciplina de Geriatria / Departamento de Clínica Médica / Faculdade de Medicina de Botucatu / UNESP Av. Rubião Jr, s/n 18618-294 Botucatu SP - Brazil. E-mail: alessandrojacinto@uol.com.br