Prevalencia y manejo terapéutico de la demencia en centros residenciales para la tercera edad del Principado de Asturias

Abstract

Objectives To study the prevalence of cognitive decline and dementia in the residential environment, the pharmacological and non-pharmacological treatments used, and the possible existence of undiagnosed dementia. Material and methods We performed a cross-sectional epidemiological study in a population of 215 elderly persons institutionalized in October 2007 in three nursing homes in Asturias. Socio-demographic, clinical, functional and mental variables were collected through a predefined study protocol. Results A total of 215 elderly individuals were included in the study (mean ± standard deviation [SD] 81.2±10.2 years, 70.2% women). Barthel Index scores were 50.63±37.43, Mini-Mental State Examination (MMSE) scores were 14.71±9.73 and Geriatric Depression Scale (GDS) scores were 3.63±3.74. Dementia had been diagnosed in 34.4%, the most prevalent cause being Alzheimer's disease (20.9%). Among patients diagnosed with dementia, 45.9% received specific pharmacological treatment for Alzheimer's disease. Among elderly residents who had attended school, 77.8% had MMSE scores below 24 and 32.9% were diagnosed with dementia. Among individuals that had not attended school, 75% had MMSE scores below 18 and 39.6% were diagnosed with dementia. Conclusions In our study population, approximately 76% of nursing home residents showed some degree of cognitive decline, 1 out of 3 residents had been diagnosed with dementia and about half were receiving specific pharmacological treatment. The results show that approximately 40% of elderly individuals admitted to nursing homes with cognitive impairment lack a clear diagnosis of the syndrome or its cause.