Differences in diagnosis, follow-up and treatment of patients with dementia living in the peripheral areas compared with the central areas of Israel.

We compared data regarding diagnosis, treatment and follow-up of patients with dementia in the central and the peripheral areas of Israel. Data were collected from the medical records of 164 patients with advanced dementia, all residents of dementia special care units - 97 patients from a central nursing home and 67 patients from the peripheral areas. The data collected related to the period prior to hospitalization and included: demographic data, imaging tests, follow-up by a memory clinic and drug treatment prior to admission. Mini Mental State Examination on admission was also recorded. Patients in the peripheral areas were hospitalized while having better cognitive function, as demonstrated by the Mini Mental State Examination (p < 0.05). More patients in the central areas versus the peripheral areas were aided by an in-house worker prior to admission (p < 0.001). More patients with dementia in the central areas were followed up by a memory clinic (p < 0.001) and underwent brain imaging (p < 0.01) compared with patients with dementia living in the peripheral areas. Although not significant, patients from the central areas were more commonly treated with atypical neuroleptics for behavioral problems (p = 0.05). On the basis of the current data, we suggest that there are differences in the diagnosis, follow-up and drug treatment among patients with dementia living in the central areas versus those living in the peripheral ones. Patients in the peripheral areas are hospitalized while their cognitive abilities are relatively better than those of the patients in central areas.

Home accidents in Al-Khobar city, eastern province, Saudi Arabia: a case-control socioeconomic study.

A one-month prospective case-control study was conducted in two sectors of Al-Khobar City (Saudi population of 65,070) with the objective of identifying the socioeconomic factors that are related to home accidents among Saudis. All accidents reported to 20 health facilities during the period were recorded and for the home accidents a questionnaire was completed at the Emergency Rooms (ERs) and the subjects were subsequently interviewed at their homes. Of the 1,104 Saudis who reported to the ERs of these health facilities 209 (18.9 percent) had home accidents. 206 were interviewed at home together with 448 families (controls) randomly drawn from the family folders at the primary health care centers in the two sectors. In the event 25 more home accidents were identified and the number of control families was accordingly reduced to 423 while the accidents increased to 231. The overall incidence rate was 355/100,000 Saudis per month, being lower (327.6/100,000) for the first sector (Al-Thougba) with a population of a relatively lower socioeconomic status than the second (Al-Khobar) sector (399.5/100,000). The number of home accidents was related to family size and was also larger in families living in villas and flats compared to single story and portable buildings. Families with home accidents had significantly more members than the controls. It is recommended that extensive community-oriented research be conducted to identify, evaluate, and subsequently control the environmental and human factors that contribute to the incidence and outcome of home accidents in Saudi Arabia.