Clinical Review of Dementia Inpatients in Geriatric Hospital: Focused on the Change in Cognitive Function According to the Vascular Risk Factors

ABSTRACT

BACKGROUND: Recent studies have shown that vascular risk factors may involved in Alzheimer's disease as well as vascular dementia. The main purpose of our study is to review the clinical characteristics of dementia inpatients and to investigate how much vascular risk factors influence the cognition of dementia inpatients for 1 year. METHODS: Between July and August in 2004, 69 dementia inpatients meeting DSM-IV criteria were examined with reviewing their charts carefully and inteviewing them directly. MMSE-K(Mini-Mental State Examination-Korean version) was used to evaluate the cognitive function of dementia inpatients. Vascular risk factors included in this study were DM, hypertension, cholesterol, homocysteine, Apolipoprotein E. RESULTS: Of the 69 dementia inpatients, 33 cases were Alzheimer's disease, 18 cases vascular dementia, 7 cases mixed dementia, 5 cases alcoholic dementia, 5 cases dementia due to brain trauma and 1 case parkinson's disease with dementia, respectively. The mean MMSE-K scores of dementia inpatients were 10.7 points at the time of admission and 9.4 points after about 1 year. Average annual rate of decline in the MMSE-K was 2.2 points in dementia inpatients with Alzheimer Disease. In comparison between dementia inpatients with vascular risk factors(DM, hypertension, cholesterol, homocysteine, APOE epsilon4 genotype) and those without vascular risk factors, there were no differences in average annual rates of decline in the MMSE-K between two groups at each vascular risk factor. According to the presence of APOE epsilon4 genotype, in spite of no difference in age, there was significant difference in the mean MMSE-K scores between two groups at the time of admission. CONCLUSION: These results suggest that Vascular risk factors(DM, hypertension, cholesterol, homocysteine, APOE epsilon4 genotype) do not influence the rates of decline in cognition of dementia inpatients significantly.