Epidemiological study of the prognosis and relevant factors of demented patients

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One hundred twenty patients diagnosed as having dementia at the Center for Elderly Dementia in Hyogo College of Medicine, were recruited for this study to investigate the factors related to the prognosis of dementia. Patients were classified into the following two groups: those staying at home (group 1); those who died at home (group 2). The proportion of various dementias was almost equal in each group: vascular dementia, 30%; senile dementia of Alzheimer's type, 40%; mixed dementia, 20%; Alzheimer's disease, 10%. The average duration of disease in the two groups were not significantly different. The average age of onset in group 2 was higher than that in group 1. The rate of those with severe dementia was higher in group 2 than group 1. Those in group 2 scored less on the Mini-Mental State examination than those in group 1. Symptoms of dementia were assessed by the modified GBS-scale. In group 2, patients scored higher in impaired intellectual and motor functions. The CT findings suggested cortical atrophy, ventricular enlargement and periventricular lucency more often in group 2 than in group 1. Laboratory findings revealed that decrease in red blood cell count, hemoglobin, hematocrit and serum protein were more apparent in group 2 than group 1. It was considered that impaired motor functions, cortical atrophy, white matter lesions, anemia and malnutrition enhanced the probability of death. The study has confirmed that the prognosis of dementia is not only related to intellectual impairment but also deteriorated physical conditions such as motor dysfunction, anemia and malnutrition.