Epidemiological and Clinical Study of Dementia in the Elderly Institutions

We have studied prevalence of dementia types in nursing homes and a geriatric hospital. We divided dementia into 4 categories, and then clinically investigated each category. Our geriatric hospital and the satellite nursing homes were divided into 4 types; home with modarate fee, home for the elderly, special nursing home for aged, and geriatric hospital. Over 60s, excluding the severely ill and mentally retarded, were selected, and Hasegawa's dementia rating scale was administered. We diagnosed dementia in those who could not get a score over 21 points or in those who met the criteria of DSM-III. Next, neurologists examined the patients, and the etiology of dementia was estimated by synthetic clinical diagnostic procedure including history, course, neurological findings, CT scan, etc. In a total of 747 cases we diagnosed 316 cases (42.3%) of dementia. The prevalence of dementia has close relation to aging and the more elderly the patient the higher the prevalence of dementia. The lower the score of ADL (activities of daily living), the higher the prevalence of dementia. The severity of dementia had some relation to the type of the nursing home. We subdivided the demented patients by etiology into 4 categories-51.6% Vascular type, 21.8% Alzheimer type, 9.2% Mixed type and 17.4% the Others. The prevalence of Vascular and Alzhemer type was higher among females, and as for Alzhemer type, there was even a greater prevalence among 70-89 year old females. Selecting patients who could get over 10 points by Hasegawa's dementia rating scale, we compared the rate of correct answers in each question. For the question “What is the date?” the vascular patients got a significantly higher rate of correct answers and for questions such as “subtruct 7 form 100” or “say some numbers backwards” Alzheimer patients scored higher. Neuropsychiatric findings had shown that there were specific symptoms in each types of dementia. And it was interesting that physical complications were seen high late in demented patients.