Objective: There are no studies that investigated the non-cognitive symptoms of patients with dementia such as depression, agitation, or delusions among general hospital in-patients. The aim of this study was to investigate the frequency of such non-cognitive symptoms among medical in-patients and to analyze their impact on the length of hospital stay and on admission to nursing homes.
Design: Epidemiological survey among medical in-patients.
Materials and Methods: The sample consisted of 372 elderly in-patients admitted to 4 internal medical departments (i.e. not including psychiatric wards) in Austria. Patients were investigated by research psychiatrists using the old-age version of the Clinical Interview Schedule. For the analyses of the non-cognitive symptomatology, only marked and severe symptoms were included. To identify predictors for the length of hospital stay and for nursing home placement, multivariate regression procedures were used.
Results: Of all in-patients, 27.4% met criteria for dementia according to DSM-III-R, 27.8% of whom had marked or severe non-cognitive symptoms. A diagnosis of dementia markedly increased the risk for nursing home referral and prolonged the duration of in-patient treatment. Among the demented, both cognitive and non-cognitive symptoms turned out to be significant predictors for nursing home placement and for a prolonged duration of the hospital stay even in the case of controlling for other independent variables.
Conclusion: Non-cognitive symptoms of dementia occur frequently among medical in-patients and considerably increase both the duration of in-patient treatment and the risk of nursing home referral. Since such non-cognitive symptoms might be treatable, they should receive sufficient attention from the hospital staff.
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