A systematic review of the prevalence, associations and outcomes of dementia in older general hospital inpatients

2010 ◽  
Vol 23 (3) ◽  
pp. 344-355 ◽  
Author(s):  
Naaheed Mukadam ◽  
Elizabeth L. Sampson
Keyword(s):  
Older People ◽  
General Hospital ◽  
English Language ◽  
Functional Decline ◽  
Acute Hospital ◽  
Diagnostic Tools ◽  
Prevalence Estimates ◽  
Hospital Stays ◽  
Medical Wards ◽  
Demographic Features

ABSTRACTBackground: Older people are commonly admitted to the acute hospital and increasing numbers will have dementia. In this study we systematically reviewed the prevalence, associations and outcomes of dementia in older people in the general hospital, to examine the range of diagnostic tools used and highlight gaps in the literature.Methods: We searched the English language literature using Embase, PsychInfo and Medline. Studies were included if they used validated criteria for diagnosing dementia, involved subjects over the age of 55 years and were set in the general hospital.Results: Fourteen papers were identified. Prevalence estimates for dementia in studies with robust methodology were 12.9–63.0%. Less than a third of studies screened for delirium or depression and therefore some subjects may have been misclassified as having dementia. The data were highly heterogeneous and prevalence estimates varied widely, influenced by study setting and demographic features of the cohorts. Patients with dementia in the acute hospital are older, require more hours of nursing care, have longer hospital stays, and are more at risk of delayed discharge and functional decline during admission.Conclusions: When planning liaison services, the setting and demographic features of the population need to be taken into account. Most study cohorts were recruited from medical wards. More work is required on the prevalence of dementia in surgical and other specialties. A wider range of associations (particularly medical and psychiatric comorbidity) and outcomes should be studied so that care can be improved.

scholarly journals Diagnosis of Anosmia and Hyposmia: A Systematic Review

2021 ◽  
Vol 12 ◽  
pp. 215265672110265
Author(s):  
Abdul K. Saltagi ◽  
Mohamad Z. Saltagi ◽  
Amit K. Nag ◽  
Arthur W. Wu ◽  
Thomas S. Higgins ◽  
...  
Keyword(s):  
English Language ◽  
Viral Infections ◽  
Original Data ◽  
Olfactory Dysfunction ◽  
Imaging Modalities ◽  
Diagnostic Tools ◽  
Validity And Reliability ◽  
Medical Subject Headings ◽  
Level Of Evidence ◽  
Smell Tests

Background Anosmia and hyposmia have many etiologies, including trauma, chronic sinusitis, neoplasms, and respiratory viral infections such as rhinovirus and SARS-CoV-2. We aimed to systematically review the literature on the diagnostic evaluation of anosmia/hyposmia. Methods PubMed, EMBASE, and Cochrane databases were searched for articles published since January 1990 using terms combined with Medical Subject Headings (MeSH). We included articles evaluating diagnostic modalities for anosmia, written in the English language, used original data, and had two or more patients. Results A total of 2065 unique titles were returned upon the initial search. Of these, 226 abstracts were examined, yielding 27 full-text articles meeting inclusion criteria (Level of evidence ranging from 1 to 4; most level 2). The studies included a total of 13,577 patients. The most utilized diagnostic tools were orthonasal smell tests (such as the Sniffin’ Sticks and the UPSIT, along with validated abridged smell tests). Though various imaging modalities (including MRI and CT) were frequently mentioned in the workup of olfactory dysfunction, routine imaging was not used to primarily diagnose smell loss. Conclusion The literature includes several studies on validity and reliability for various smell tests in diagnosing anosmia. Along with a thorough history and physical, validated orthonasal smell tests should be part of the workup of the patient with suspected olfactory dysfunction. The most widely studied modality was MRI, but criteria for the timing and sequence of imaging modalities was heterogenous.

Alternatives to acute hospital care

2001 ◽  
Vol 11 (4) ◽  
pp. 373-378 ◽  
Author(s):  
H Gentles ◽  
J Potter
Keyword(s):  
Older People ◽  
Acute Hospital ◽  
Intermediate Care ◽  
National Service ◽  
Acute Hospital Care ◽  
Department Of Health ◽  
Health Authorities ◽  
National Service Framework ◽  
Hospital Beds ◽  
Service Framework

The National Bed Inquiry indicated that up to 20% of older people might be inappropriately occupying acute hospital beds and could be discharged if alternative services were available. The report proposed the concept of ‘Intermediate Care’ as a scenario that might contribute to resolving issues around the use of acute hospital beds. The Department of Health (DoH) Circular to Health Authorities and Local Councils with regard to Intermediate Care and the publication of the National Service Framework for Older People have brought intermediate care into mainstream health policy.

Rapid Emergency Department Intervention for Older People Reduces Risk of Functional Decline: Results of a Multicenter Randomized Trial

2001 ◽  
Vol 49 (10) ◽  
pp. 1272-1281 ◽  
Author(s):  
Jane McCusker ◽  
Josee Verdon ◽  
Pierre Tousignant ◽  
Louise Poulin de Courval ◽  
Nandini Dendukuri ◽  
...  
Keyword(s):  
Emergency Department ◽  
Older People ◽  
Randomized Trial ◽  
Functional Decline ◽  
Multicenter Randomized Trial

Screening for depression in older people on medical wards: which cut‐point should we use?

2003 ◽  
Vol 18 (4) ◽  
pp. 358-359 ◽  
Author(s):  
Sarah Cullum ◽  
Harpal Nandhra ◽  
Jon Darley ◽  
Chris Todd
Keyword(s):  
Older People ◽  
Cut Point ◽  
Medical Wards

Maintaining independence in older people

2010 ◽  
Vol 20 (2) ◽  
pp. 128-153 ◽  
Author(s):  
AD Beswick ◽  
R Gooberman-Hill ◽  
A Smith ◽  
V Wylde ◽  
S Ebrahim
Keyword(s):  
Older People ◽  
Social Engagement ◽  
Hospital Admissions ◽  
Meta Analysis ◽  
Functional Decline ◽  
Complex Interventions ◽  
Preventive Strategies ◽  
Health And Social Care ◽  
Quality Trial ◽  
High Quality Trial

SummaryAppropriate social and medical interventions may help maintain independence in older people. Determinants of functional decline, disability and reduced independence are recognized and specific interventions target the treatment of clinical conditions, multiple health problems and geriatric conditions, prevention of falls and fractures, and maintenance of physical and cognitive function and social engagement.Preventive strategies to identify and treat diverse unmet needs of older people have been researched extensively. We reviewed systematically recent randomized controlled trials evaluating these ‘complex’ interventions and incorporated the findings of 21 studies into an established meta-analysis that included 108,838 people in 110 trials. There was an overall benefit of complex interventions in helping older people to live at home, explained by reduced nursing home admissions rather than death rates. Hospital admissions and falls were also reduced in intervention groups. Benefits were largely restricted to earlier studies, perhaps reflecting general improvements in health and social care for older people. The wealth of high-quality trial evidence endorses the value of preventive strategies to help maintain independence in older people.

Falls

2017 ◽  
pp. 373-382
Author(s):  
Clemens Becker ◽  
Jean Woo ◽  
Chris Todd
Keyword(s):  
Older People ◽  
Best Practice ◽  
Long Term Care ◽  
Acute Hospital ◽  
Screening Tools ◽  
Term Care ◽  
Risk Factors For Falls ◽  
Use Of Health Services

Falls are very common among older people, with 30–40% of people aged 65 or over falling each year. Incidence increases with age, is particularly high in residential care settings, and has a considerable burden in terms of morbidity, mortality, use of health services, and reductions in quality of life. In the first section of this chapter we define falls, then review the epidemiology of falls in the community, and acute hospital, residential, and long-term care. We review and identify the major risk factors for falls and the assessment and screening tools used to detect risk and resources of best practice recommendations for clinical practice. In the second section, we provide overviews of best practice in prevention and clinical management, first for older people living independently in the community, then for acute hospital care, and thirdly for residential and long-term care.

scholarly journals Social Participation and Functional Decline: A Comparative Study of Rural and Urban Older People, Using Japan Gerontological Evaluation Study Longitudinal Data

2020 ◽  
Vol 17 (2) ◽  
pp. 617 ◽  
Author(s):  
Kazushige Ide ◽  
Taishi Tsuji ◽  
Satoru Kanamori ◽  
Seungwon Jeong ◽  
Yuiko Nagamine ◽  
...  
Keyword(s):  
Longitudinal Data ◽  
Older People ◽  
Social Participation ◽  
Urban Areas ◽  
Proportional Hazards Model ◽  
Functional Decline ◽  
Evaluation Study ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Rural And Urban

This study compared the relationship between social participation, including work, and incidence of functional decline in rural and urban older people in Japan, by focusing on the number and types of organizations older people participated in. The longitudinal data of the Japan Gerontological Evaluation Study (JAGES) that followed 55,243 individuals aged 65 years or older for six years were used. The Cox proportional hazards model was employed to calculate the hazard ratio (HR) of the incidence of functional decline over six years and the stratification of rural and urban settings. In this model, we adjusted 13 variables as behavioral, psychosocial, and functional confounders. The more rural and urban older people participated in various organizations, the more they were protected from functional decline. Participation in sports (HR: rural = 0.79; urban = 0.83), hobby groups (HR: rural = 0.76; urban = 0.90), and work (HR: rural = 0.83; urban = 0.80) significantly protected against the incidence of decline in both rural and urban areas. For both rural and urban older people, promoting social participation, such as sports and hobby groups and employment support, seemed to be an important aspect of public health policies that would prevent functional decline.

Sign in / Sign up

Export Citation Format

Share Document