BACKGROUND: a large and increasing number of older people in the UK are living in care homes. Dementia is a frequent reason underlying admission and determining care needs, but prevalence data are becoming increasingly outdated and reliant on brief screening instruments. OBJECTIVE: to describe the prevalence and severity of dementia, depression, behavioural problems and relevant medication use in a representative sample of residential and nursing care home residents. DESIGN/ SETTING: a survey conducted in 15 randomly selected South East London care homes. Consensus clinical dementia diagnoses were made from multi-source information, and the Clinical Dementia Rating (CDR) Scale applied. Depression was ascertained using the Cornell Depression in Dementia Scale and psychological/behavioural problems using the Neuropsychiatric Inventory (NPI). PARTICIPANTS: three hundred and one residents with a mean (SD) age of 83.5 (9.8) and 65.8% female were included. RESULTS: dementia (CDR 1-3) prevalence was 75.1% overall, 55.8% in residential homes, 91.0% in residential elderly mentally infirm care and 77.0% in nursing homes. Depression prevalences were 26.5, 22.0 and 29.6%, respectively, and mean (95% CI) NPI severity scores 3.99 (3.47-4.50), 6.34 (5.29-7.39) and 6.10 (5.50-6.70) with 87.3% of the sample exhibiting at least one NPI symptom. Antidepressants were prescribed in 25.6, 25.0 and 41.3%, respectively, and antipsychotics in 7.0, 34.1 and 19.1%. CONCLUSION: dementia is substantially more common in care homes than recorded diagnoses would suggest, but studies using brief screening instruments may overestimate prevalence. High prevalences of depressive and/or behavioural symptoms and psychotropic use suggest significant unmet need.
BACKGROUND: a large and increasing number of older people in the UK are living in care homes. Dementia is a frequent reason underlying admission and determining care needs, but prevalence data are becoming increasingly outdated and reliant on brief screening instruments. OBJECTIVE: to describe the prevalence and severity of dementia, depression, behavioural problems and relevant medication use in a representative sample of residential and nursing care home residents. DESIGN/ SETTING: a survey conducted in 15 randomly selected South East London care homes. Consensus clinical dementia diagnoses were made from multi-source information, and the Clinical Dementia Rating (CDR) Scale applied. Depression was ascertained using the Cornell Depression in Dementia Scale and psychological/behavioural problems using the Neuropsychiatric Inventory (NPI). PARTICIPANTS: three hundred and one residents with a mean (SD) age of 83.5 (9.8) and 65.8% female were included. RESULTS:dementia (CDR 1-3) prevalence was 75.1% overall, 55.8% in residential homes, 91.0% in residential elderly mentally infirm care and 77.0% in nursing homes. Depression prevalences were 26.5, 22.0 and 29.6%, respectively, and mean (95% CI) NPI severity scores 3.99 (3.47-4.50), 6.34 (5.29-7.39) and 6.10 (5.50-6.70) with 87.3% of the sample exhibiting at least one NPI symptom. Antidepressants were prescribed in 25.6, 25.0 and 41.3%, respectively, and antipsychotics in 7.0, 34.1 and 19.1%. CONCLUSION:dementia is substantially more common in care homes than recorded diagnoses would suggest, but studies using brief screening instruments may overestimate prevalence. High prevalences of depressive and/or behavioural symptoms and psychotropic use suggest significant unmet need.
Authors: Orlagh Feehan; David J Armstrong; Pamela J Magee; Kirsty L Pourshahidi; J J Strain; Laura Beggan; Diego F Cobice; Emeir M McSorley Journal: Nutrients Date: 2022-06-28 Impact factor: 6.706
Authors: Martin Knapp; Kia-Chong Chua; Matthew Broadbent; Chin-Kuo Chang; Jose-Luis Fernandez; Dominique Milea; Renee Romeo; Simon Lovestone; Michael Spencer; Gwilym Thompson; Robert Stewart; Richard D Hayes Journal: BMJ Open Date: 2016-11-18 Impact factor: 2.692
Authors: Najma Siddiqi; Francine Cheater; Michelle Collinson; Amanda Farrin; Anne Forster; Deepa George; Mary Godfrey; Elizabeth Graham; Jennifer Harrison; Anne Heaven; Peter Heudtlass; Claire Hulme; David Meads; Chris North; Angus Sturrock; John Young Journal: Age Ageing Date: 2016-05-20 Impact factor: 10.668
Authors: Fiona E Matthews; Holly Bennett; Raphael Wittenberg; Carol Jagger; Tom Dening; Carol Brayne Journal: PLoS One Date: 2016-09-02 Impact factor: 3.240