Dementia and Delirium Among Elderly Patients in a General Hospital Medical Ward / 신경정신의학

ABSTRACT

OBJECTS:The authors attempted to estimate the prevalence of cognitive impairments (dementia and delirium) among elderly patients, the main causes of delirium, and the extent of physicians' recognition of cognitive impairment in a general hospital medical ward. METHODS: A 4-month prospective study of 312 patients(65 years and older) was conducted with cognitive function screened with Mini-Mental State Examination-K and the Confusion Assessment Method. The subjects were diagnosed according to DSM-IV criteria for dementia and delirium. The physicians' assessment of cognitive capacity was done through the chart review for recording cognitive deficits. RESULTS: In thirty-three(13.87%) of the 238 patients, cognitive impairment was present. It was further diagnosis as dementia in 19(13.9%) patients or delirium in 14(8.0%) patients. The mean length of hospital stay in all age groups was 13.1 +/- 10.6 days with no differences among the 3 groups(dementia, delirium, and control) The main causes for delirium were infection, metabolic disorder, cerebrovascular accident and alcohol withdrawl. The recovery of delirium was observed of 10 of 14 patients before discharge. Regarding the physicians' recognition of cognitive impairment, delirious symptoms were recorded in 9 of 14 patients and dementic symptoms were recorded in only one patient. CONCLUSION: This study suggests that further systematic assessment is necessary to improve physicians recognition of cognitive impairments in the elderly medical inpatients.