Abstract
Aims and MethodWe studied a representative cohort of 161 patients over 65 years of age, admitted non-electively to medical and geriatric wards of a large teaching hospital. Assessment for dementia was made using DSM–IV criteria. Psychiatric records were then examined, masked, to determine the involvement of psychogeriatric services.ResultsThere were 111 possible cases of dementia (69%), of which 30 (27%) had prior local psychogeriatric case notes; in 22 cases (20%) the patient had a prior psychiatric diagnosis of dementia. of 161 patients, 19 (12%) were seen by psychogeriatric services during their admission, of whom 12 (7%) were already known to psychiatric services. Dementia was diagnosed in 17 (complicated by delirium in 2), depression in 1 and hypomania in 1. Many patients with a possible diagnosis of dementia had no psychiatric assessment.Clinical ImplicationsPsychogeriatric assessment was performed on a minority of older people admitted to medical care. This population may include older people with undiagnosed dementia and unmet psychiatric care needs.
Highlights
20% of patients considered by Department of Medicine for the Elderly (DoME) staff to have dementia were known to psychiatric services as having dementia
A minority were referred during the study period as new cases
It would seem that the majority of individuals with dementia in our sample were being managed by primary care and other services without ever coming to the attention of mental health services
Summary
We studied a representative cohort of 161 patients over 65 years of age, admitted non-electively to medical and geriatric wards of a large teaching hospital. Assessment for dementia was made using DSM-IV criteria. Psychiatric records were examined, masked, to determine the involvement of psychogeriatric services
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