RESUMO
Objetivos. Estudiar la prevalencia de delirium en ancianos institucionalizados en residencias para personas mayores; analizar los posibles factores clínicos, funcionales y mentales asociados. Material y métodos. Estudio epidemiológico transversal sobre una población de mayores de 65 años institucionalizados en 2011 en 6 residencias de Asturias. Se recogieron variables sociodemográficas, clínicas, funcionales (índice de Barthel [IB]), mentales (Mini-Mental State Examination [MMSE]). El diagnóstico de delirium se realizó en base al Confusion Assessment Method. Resultados. Quinientos cinco sujetos fueron incluidos en el estudio (83,30 ± 7,33 años; 67,70% mujeres; MMSE 17,19 ± 10,35; IB 55,11 ± 35,82). Se detectó una prevalencia de delirium del 11,70%. Se observó asociación estadística con delirium de: puntuación en IB, puntuación en MMSE, presencia de demencia, de úlceras por presión o de sonda urinaria y ser tratados con clometiazol, con inhibidores de la colinesterasa o con trazodona. Al realizar un análisis de regresión logística permanecieron como variables en el modelo la puntuación en el Barthel, el diagnóstico de demencia y el ser tratados con clometiazol o trazodona. Conclusiones. Para nuestra población de estudio, el 11,7% de los sujetos institucionalizados presenta delirium. Según los resultados obtenidos, la puntuación en IB así como la existencia de demencia y la prescripción de clometiazol o trazodona son factores que se asocian a la presencia de delirium en el medio residencial (AU)
Objectives. To study the prevalence of delirium in the residential environment and to analyse the associated clinical, functional and mental factors. Material and methods. A cross-sectional epidemic study was conducted on a population of elderly persons institutionalised in 2011 in 6 nursing homes in Asturias. Socio-demographic, clinical, functional (Barthel Index [BI]) and mental (Mini-Mental State Examination [MMSE]) variables were collected. Delirium was defined by the Confusion Assessment Method. Results. A total of 505 elderly were included in the study (age 83.30 ± 7.33 years, with 67.70% women), and scores on the MMSE of 17.19 ± 10.35 and a BI score of 55.11 ± 35.82. The prevalence of delirium was 11.70%. On examining the risk of delirium among the studied variables, there was statistical significance when considering: BI, MMSE, dementia, pressure ulcers, or urinary catheter, and the prescribing of clomethiazole, ACTH-I or trazodone. In the analysis of the variables in the logistic regression with BI, diagnosis of dementia, the prescribing of clomethiazole or trazodone, in the equation, there was a statistical significance associated with delirium. Conclusions. The prevalence of delirium in a residential environment in our study population was 11.7%. The results show that BI, diagnosis of dementia, and prescribing of clomethiazole or trazodone were associated with risk of delirium in institutionalised patients (AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Transtornos Neurocognitivos/epidemiologia , Transtornos Neurocognitivos/prevenção & controle , Delírio/epidemiologia , Doença de Alzheimer/epidemiologia , Doença de Alzheimer/prevenção & controle , Demência/epidemiologia , Demência/prevenção & controle , Saúde do Idoso Institucionalizado , Estudos Transversais/métodos , Trazodona/uso terapêutico , Intervalos de ConfiançaRESUMO
OBJECTIVES: To study the prevalence of delirium in the residential environment and to analyse the associated clinical, functional and mental factors. MATERIAL AND METHODS: A cross-sectional epidemic study was conducted on a population of elderly persons institutionalised in 2011 in 6 nursing homes in Asturias. Socio-demographic, clinical, functional (Barthel Index [BI]) and mental (Mini-Mental State Examination [MMSE]) variables were collected. Delirium was defined by the Confusion Assessment Method. RESULTS: A total of 505 elderly were included in the study (age 83.30 ± 7.33 years, with 67.70% women), and scores on the MMSE of 17.19 ± 10.35 and a BI score of 55.11 ± 35.82. The prevalence of delirium was 11.70%. On examining the risk of delirium among the studied variables, there was statistical significance when considering: BI, MMSE, dementia, pressure ulcers, or urinary catheter, and the prescribing of clomethiazole, ACTH-I or trazodone. In the analysis of the variables in the logistic regression with BI, diagnosis of dementia, the prescribing of clomethiazole or trazodone, in the equation, there was a statistical significance associated with delirium. CONCLUSIONS: The prevalence of delirium in a residential environment in our study population was 11.7%. The results show that BI, diagnosis of dementia, and prescribing of clomethiazole or trazodone were associated with risk of delirium in institutionalised patients.
Assuntos
Delírio/epidemiologia , Instituição de Longa Permanência para Idosos , Casas de Saúde , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Fatores de RiscoRESUMO
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.
Assuntos
Demência/epidemiologia , Demência/terapia , Instituição de Longa Permanência para Idosos , Casas de Saúde , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , EspanhaRESUMO
Objetivosestudiar la prevalencia de deterioro cognoscitivo y de demencia en el medio residencial, los tratamientos farmacológicos y no farmacológicos utilizados y la posible existencia de demencia no diagnosticada.Material y métodosestudio epidemiológico transversal sobre una población de 215 ancianos institucionalizados en octubre de 2007 en 3 centros residenciales del Principado de Asturias. Mediante un protocolo de estudio predefinido, se recogieron variables sociodemográficas, clínicas, funcionales y mentales.Resultadosse incluyó a 215 ancianos en el estudio (edad media±desviación estándar [DE], 81,2±10,2 años; 70,2% mujeres), puntuaciones medias (±DE) en el índice de Barthel 50,63±37,43, en el Mini-Mental State Examination (MMSE) 14,71±9,73 y en la escala de depresión geriátrica de Yesavage (GDS) 3,63±3,74. El 34,4% había sido diagnosticado de demencia; la causa más prevalente fue la enfermedad de Alzheimer (20,9%). De los pacientes con diagnóstico de demencia, el 45,9% recibía algún tratamiento farmacológico específico para el Alzheimer. En los sujetos escolarizados, el 77,8% tenía puntuaciones en el MMSE inferiores a 24 y el 32,9% estaba diagnosticado de demencia; en los sujetos sin escolarización, el 75% tenía puntuaciones en el MMSE inferiores a 18 y el 39,6% estaba diagnosticado de demencia.Conclusionespara nuestra población de estudio, alrededor del 76% de los sujetos presenta algún grado de deterioro cognoscitivo, 1 de cada 3 residentes fue diagnosticado de demencia y cerca de la mitad está recibiendo un tratamiento farmacológico específico. Según los resultados obtenidos, aproximadamente el 40% de los ancianos ingresados con problemas cognoscitivos no tienen un diagnóstico claro del síndrome demencial ni de la causa de éste (AU)
ObjectivesTo 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 methodsWe 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.ResultsA 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.ConclusionsIn 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 (AU)
