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Demented versus non-demented very old inpatients: the same comorbidities but poorer functional and nutritional status.

Abstract

BACKGROUND

demented patients have been reported to be healthier than other old people of the same age.

OBJECTIVES

to assess comorbid conditions, functional and nutritional status in medically ill hospitalised patients with normal cognition or affected by dementia of various causes and severities, or mild cognitive impairment (MCI).

DESIGN AND SETTING

a prospective study was carried out, between January and December 2004, in the Rehabilitation and Geriatric Hospital (HOGER).

METHODS

activities of daily living (ADL), instrumental activities of daily living (IADL) and mini nutritional assessment (MNA) scores were assessed as a function of the status of the patient two weeks before admission to hospital. On admission, cognitive status was assessed by a systematic battery of neuropsychological tests, comorbid conditions were assessed with the Charlson comorbidity index (CCI), and body mass index (BMI) and functional independence measure (FIM) were determined. BMI and FIM were also determined on discharge.

RESULTS

we studied 349 patients (mean age 85.2 +/- 6.7; 76% women): 161 (46.1%) cognitively normal, 37 (10.6%) with MCI and 151 (43.3%) demented (61 Alzheimer's disease (AD), 62 mixed dementia (MD) and 17 vascular dementia (VaD)). ADL, IADL, FIM and MNA scores on admission decreased with cognitive status, regardless of the type of dementia. Functionality at discharge remained significantly lower in demented patients than in other patients. CCI was high and similar in all three groups (mean 4.6 +/- 2.7). Patients with VaD had poorer health than other demented patients, with a higher average comorbidity score, more frequent hypertension, stroke and hyperlipidaemia. Comorbidity did not increase with severity levels of dementia.

CONCLUSIONS

in this cohort of very old inpatients, demented patients, non-demented patients and patients with MCI had similar levels of comorbidity, but demented patients had a poorer functional and nutritional status.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Geneva University, Rehabilitation and Geriatrics Department, 3, chemin du Pont-Bochet, CH-1226, Thônex, Switzerland. dina.zekry@hcuge.ch

    , , , , ,

    Source

    Age and ageing 37:1 2008 Jan pg 83-9

    MeSH

    Activities of Daily Living
    Aged
    Aged, 80 and over
    Alzheimer Disease
    Body Mass Index
    Cardiovascular Diseases
    Cognition Disorders
    Comorbidity
    Dementia
    Dementia, Vascular
    Female
    Follow-Up Studies
    Hospitalization
    Humans
    Male
    Neuropsychological Tests
    Nutrition Assessment
    Nutritional Status
    Prospective Studies
    Risk Factors

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    17971391

    Citation

    Zekry, Dina, et al. "Demented Versus Non-demented Very Old Inpatients: the Same Comorbidities but Poorer Functional and Nutritional Status." Age and Ageing, vol. 37, no. 1, 2008, pp. 83-9.
    Zekry D, Herrmann FR, Grandjean R, et al. Demented versus non-demented very old inpatients: the same comorbidities but poorer functional and nutritional status. Age Ageing. 2008;37(1):83-9.
    Zekry, D., Herrmann, F. R., Grandjean, R., Meynet, M. P., Michel, J. P., Gold, G., & Krause, K. H. (2008). Demented versus non-demented very old inpatients: the same comorbidities but poorer functional and nutritional status. Age and Ageing, 37(1), pp. 83-9.
    Zekry D, et al. Demented Versus Non-demented Very Old Inpatients: the Same Comorbidities but Poorer Functional and Nutritional Status. Age Ageing. 2008;37(1):83-9. PubMed PMID: 17971391.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Demented versus non-demented very old inpatients: the same comorbidities but poorer functional and nutritional status. AU - Zekry,Dina, AU - Herrmann,François R, AU - Grandjean,Raphael, AU - Meynet,Marie-Pierre, AU - Michel,Jean-Pierre, AU - Gold,Gabriel, AU - Krause,Karl-Heinz, Y1 - 2007/10/30/ PY - 2007/11/1/pubmed PY - 2008/2/22/medline PY - 2007/11/1/entrez SP - 83 EP - 9 JF - Age and ageing JO - Age Ageing VL - 37 IS - 1 N2 - BACKGROUND: demented patients have been reported to be healthier than other old people of the same age. OBJECTIVES: to assess comorbid conditions, functional and nutritional status in medically ill hospitalised patients with normal cognition or affected by dementia of various causes and severities, or mild cognitive impairment (MCI). DESIGN AND SETTING: a prospective study was carried out, between January and December 2004, in the Rehabilitation and Geriatric Hospital (HOGER). METHODS: activities of daily living (ADL), instrumental activities of daily living (IADL) and mini nutritional assessment (MNA) scores were assessed as a function of the status of the patient two weeks before admission to hospital. On admission, cognitive status was assessed by a systematic battery of neuropsychological tests, comorbid conditions were assessed with the Charlson comorbidity index (CCI), and body mass index (BMI) and functional independence measure (FIM) were determined. BMI and FIM were also determined on discharge. RESULTS: we studied 349 patients (mean age 85.2 +/- 6.7; 76% women): 161 (46.1%) cognitively normal, 37 (10.6%) with MCI and 151 (43.3%) demented (61 Alzheimer's disease (AD), 62 mixed dementia (MD) and 17 vascular dementia (VaD)). ADL, IADL, FIM and MNA scores on admission decreased with cognitive status, regardless of the type of dementia. Functionality at discharge remained significantly lower in demented patients than in other patients. CCI was high and similar in all three groups (mean 4.6 +/- 2.7). Patients with VaD had poorer health than other demented patients, with a higher average comorbidity score, more frequent hypertension, stroke and hyperlipidaemia. Comorbidity did not increase with severity levels of dementia. CONCLUSIONS: in this cohort of very old inpatients, demented patients, non-demented patients and patients with MCI had similar levels of comorbidity, but demented patients had a poorer functional and nutritional status. SN - 1468-2834 UR - https://www.unboundmedicine.com/medline/citation/17971391/Demented_versus_non_demented_very_old_inpatients:_the_same_comorbidities_but_poorer_functional_and_nutritional_status_ L2 - https://academic.oup.com/ageing/article-lookup/doi/10.1093/ageing/afm132 DB - PRIME DP - Unbound Medicine ER -