patients during the QI project compared to 3% at baseline. A falls
reduction was noted from 50% (n = 15) during the two months
intervention to 20% (n = 6) two months after the QI project.
The QI project resulted in increased engagement between
nursing staff and families to complete and deliver personalised care
plans including distraction activities to patients with dementia.
Increased personalised care planning was associated with a reduction
in falls incidents in an acute ward setting. The ongoing challenge is to
sustain momentum over time.
Alteration of cerebral blood flow between Alzheimer
s disease (AD)
and AD with possible dementia with Lewy bodies (AD + pDLB)
, K. Mori
, H. Maruno
, I. Hemmi
, Y. Ouchi
, Y. Igeta
Okinaka Memorial Institution for Medical Research,
Japanese Red Cross College of Nursing, Tokyo, Japan
AD and DLB are made up of a majority of dementia.
The pathology is proposed that these dementias complicatedly affect
each other and develop the diversely neurodegenerative pathway. AD
incorporated with one suggestive/supportive DLB feature, categorized
possible DLB (pDLB)
, might have different findings from AD
without the DLB feature. We evaluated regional cerebral blood flow
(CBF) in AD and AD+pDLB.
Patients with AD first visiting our facility from July to
October in 2015 were enrolled, fallen into AD criteria written by
National Institute on Aging Alzheimer
s Association. Of the patients,
those satisfied pDLB condition written by third report of the DLB
consortium were classified as AD+pDLB. Patients with definite/
probable Parkinson disease or DLB were excluded. Indexed regional
CBFs in the frontal lobe, the temporal, the parietal, the occipital,
and the parahippocampal gyrus were calculated with I-123 iodoam-
phetamine SPECT, the radiotracer presenting arterial blood varies
depending on its uptake. We compared the CBFs between AD and AD
We detected 22 with AD and 7 with AD+pDLB. The regional
CBFs were not different significantly, even though the CBF in the left
parietal lobe was marginally different (p = .07).
CBF in AD+pDLB was similar as in AD. Our initial trial
suggested that the distribution of the CBF was overlapped between
AD and AD+pDLB, reflected these complicated pathology.
Characteristics of cognitive disorders of the older patients visiting
the Memory clinic for the first time
J. Knasiene, G. Legotaite, G. Damuleviciene.
Lithuanian University of
Health Sciences, Kaunas, Lithuania
The prevalence of dementia in Lithuania has risen
dramatically in past decades and the vascular risk factors may
contribute to this rise. The proportions of Alzheimer
s disease (ADD)
and vascular dementia (VAD) in older population is not clear. Our aim
was to evaluate the characteristics of cognitive disorders of the older
patients, visiting the Memory clinic for the first time.
We used a population-based retrospective cohort study
design and extracted data from Memory clinic database.
60 year-old) data were analyzed. 82,7% of
s (n = 167) had cognitive disorders: 81,4% (n = 136) dementia,
18,6% (n = 31) mild cognitive impairment (MCI). Dementia, accord-
ing to severity: severe 15,4%, moderate 72,1%, mild 12,5%. The most
common was VAD
in 41,9% of cases (subcortical 64,9%), mixed
4,4%. MCI has relationshipwith
ischaemic heart disease (IHD), hypertension. Dementia is associated
with older age (p <0,001) and lower education of the patients
(p < 0,001). VAD is associated with strokes (p < 0,001), IHD (p = 0,003),
hypertension (p = 0,009), ischemic lacunar state (p < 0,001) and
urinary incontinence (p = <0,001), falls (p = 0,001). Mixed dementia
has relationship with IHD, hypertension, urinary incontinence.
The prevalence of cognitive disorders among the older
patients visiting the Memory clinic for the first time is high and the
most common was VAD. The high prevalence of VAD and mixed
dementia is associated with vascular risk factors
hypertension, chronic ischemic lacunar state. Community based early
interventions controlling vascular risk factors have a priority in
prevention of cognitive disorders in older population.
The level of dementia recognition among the elderly patients and
patients with diabetes hospitalized in a geriatric ward
is there a
need for screening?
, Z.B. Wojszel
Department of Geriatrics, Medical
University of Bialystok, Poland,
Department of Geriatrics, Hospital of the
Ministry of the Interior in Bialystok, Poland
Diabetes is a common disease and a recognized risk factor
for dementia in elderly patients. Dementia may adversely affect the
treatment of diabetes and increase the risk of complications. The aim
of the study was to evaluate the level of recognition of dementia
among the elderly patients and patients with diabetes admitted to a
427 patients aged 60 years or older were hospitalized in the
department between September 1st. 2015 and April 30th. 2016.
women; 85% of people 75 year old and older; average age
81,6 ± 6,75
years. A retrospective analysis of dementia prevalence (diagnosis
based on clinical and neuropsychological assessment) was conducted,
and dementia severity was determined on the basis of Mini Mental
State Examination score.
129 (30,2%) dementia cases were identified in this group
(34,1%) previously diagnosed and treated (MMSE
16 (13;21)) and 85
(65,9%) newly diagnosed (MMSE
18 (15;21)). In 130 patients with
diabetes cognitive disability was diagnosed in 33,8% of cases. In 32
(72,7%) patients it was the newly diagnosed dementia. The severity of
cognitive disability in diabetic patients assessed with MMSE was 19
(15;21) in newly diagnosed cases, and 15,5 (10,5
20) in dementia
previously diagnosed and treated.
The awareness of cognitive disability prevalence in older
patients is rather low and very frequently it is not diagnosed and
treated. It concerns also patients with diabetes, suggesting the need
for implementation of dementia screening in this group. This could
positively influence management of the disease.
Is deliriumandmemory impairment identified and acted upon in a
busy district general hospital?
L.J. Koizia, A. Porter, S-L Xiao, L. Poulton, M. Vilasuso.
Dementia and delirium affects more than a quarter of
in-patients at any one time. These patients have a higher mortality,
complication rates and increased length of stay. This has prompted
the development of the Commissioning for Quality and Innovation
(CQUIN) target and guidelines highlighting the importance of
cognitive screening in elderly patients admitted as an emergency.
We undertook a QIP to assess the number of patients admitted acutely
who had cognitive assessments performed and any actions as a result.
All patients over the age of 75 years who were admitted as
an emergency over a two-day period were assessed. The notes were
reviewed for completion of AMTS (abbreviated mental test score) and
CAMs (confusion assessment method) scores; then further investiga-
tions and referrals were assessed. In addition, the discharge summar-
ies were evaluated to identify if cognitive impairment had been
documented and if further actions were advised.
74 patients were assessed (6 excluded because they passed
away). 48% of patients had an AMTs within 72 hours of admission. In
addition, none of the patients with a low AMTS (<8) had appropriate
steps taken i.e. blood tests, referrals, information passed onto GPs, as
recommended by national guidelines. We have identified that by
Poster presentations / European Geriatric Medicine 7S1 (2016) S29