[Diogenes syndrome in the elderly: clinical form of frontal dysfunction? Report of 4 cases]. / Le syndrome de Diogène du sujet âgé: forme clinique d'un dysfonctionnement frontal? A propos de quatre observations.

PURPOSE: Diogenes syndrome is characterised by self-neglect and domestic squalor which leads to unhealthy living conditions. It seems that no single model satisfactorily explains the development of Diogenes syndrome. METHODS: We report four cases of Diogenes syndrome discovered during a short-stay geriatric hospitalization. We were able to analyse them as regards social, physical, psychiatric and cognitive aspects. RESULTS: The results showed absence of socioeconomic precariousness, psychiatric and physical pathologies which generate handicaps. A dementia characterised by a frontal dysfunction was constantly found. CONCLUSION: Diogenes syndrome seems to be a particular behavioural demonstration of a frontal lobe dementia. It does not correspond to a lucid life choice, which must encourage a medico-social assumption.

[Self health evaluation using a visual analog scale for elderly patients presenting with pain or early dementia]. / L'autoévaluation de la santé par une échelle visuelle analogique chez des sujets âgés ressentant une douleur ou ayant une démence débutante.

PURPOSE AND METHODS: Sixteen elderly patients with early dementia and 20 elderly patients with pain, all hospitalized in a geriatric hospital, evaluated their memory, health and mood, using a visual analog scale. Observations of their families and of the medical staff were also recorded for subsequent comparison. The patients' complaints were also compared to those of a control group including 16 healthy elderly subjects. RESULTS: Patients with early dementia complained more often than control subjects of memory loss and health and mood disorders, while patients with pain complained more often of only health and mood disorders. However, only patients with dementia complained of memory loss. Complaints noticed by their families and medical staff were in good agreement with theirs. Regarding patients with early dementia, the medical staff underestimated their complaint of memory loss. CONCLUSION: Visual analog scales appear to be valuable tools regarding not only evaluation of pain but also the patients' general condition. Complaints of memory loss could be of value as they would suggest the existence of early dementia in elderly patients. However, our study emphasizes the need for training medical staff to listen to such a complaint.