Dementia Diagnoses and Treatment in Geriatric Ward Patients: A Cross-Sectional Study in Poland

Clin Interv Aging. 2020 Nov 13:15:2183-2194. doi: 10.2147/CIA.S281723. eCollection 2020.

Abstract

Purpose: The study aimed to determine the prevalence of dementia, its types, and treatment in geriatric ward patients.

Patients and methods: A cross-sectional study of 406 patients (77.8% women, median age 82, IQR (77-86) years) who underwent a comprehensive geriatric assessment in one of the Polish hospitals between September 2014 and April 2015 was conducted.

Results: Dementia was diagnosed in 132 (32.5%) patients (46% mixed dementia; 32% Alzheimer's disease; 10%vascular dementia; 5% dementia in Parkinson's disease; 4% frontotemporal; 3% atypical parkinsonism). A total of 95 (72%) dementia cases were not detected before, and in the above half of these patients, it was not mentioned in the referral document. Only 33.3% of dementia patients were on cognitive enhancers (donepezil, rivastigmine, or memantine); 36.4% received antipsychotics, 45.5% received anti-depressants, 25.8% received nootropics, and 16.7% received anxiolytics/hypnotics.

Discussion: The results confirmed the high incidence of underdiagnoses and undertreatment of dementia in patients admitted to the geriatric ward. It is partly due to the lack of systematic cognitive assessment in primary care settings, although other factors can play a role.

Keywords: anti-dementia medications; anti-depressants; antipsychotics; cognitive enhancers; comprehensive geriatric assessment; dementia diagnosis; dementia treatment; geriatric ward; psychotropic medications; underdiagnoses; undertreatment.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / drug therapy
  • Antipsychotic Agents / therapeutic use*
  • Cross-Sectional Studies
  • Dementia / diagnosis*
  • Dementia / drug therapy*
  • Dementia / epidemiology
  • Donepezil / therapeutic use
  • Female
  • Geriatric Assessment
  • Hospitals
  • Humans
  • Male
  • Memantine / therapeutic use
  • Nootropic Agents / therapeutic use*
  • Poland

Substances

  • Antipsychotic Agents
  • Nootropic Agents
  • Donepezil
  • Memantine

Grants and funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The source study was supported by the Medical University of Bialystok, grant number N/ST/ZB/15/001/3301. The financial sponsor played no role in the design, execution, analysis and interpretation of data.