DEMENTIA AND ACUTE ASSOCIATED DISEASES IN ELDERLY SUBJECTS - A STUDY OF 100 PATIENTS AGED OVER 75 IN AN INTERNAL-MEDICINE AND GERIATRIC UNIT

Elderly people with dementia are admitted in ever increasing number to Internal Medicine units for exploration of dementia and treatment of intercurrent diseases. The purpose of this prospective study of 100 de mential subjects aged 75 or more (mean : 85.3 +/- 5.4 years) was to di scover the cause of dementia, to investigate the associated diseases a nd to evaluate the effects of treatment of these pathologies on the pa tients' cognitive performance. The mean duration of stay in hospital w as 25.5 +/- 14.5 days (extreme : 6-100 days) ; 69 returned home, 17 we re institutionalized and 14 died. Dementia was degenerative and of the Alzheimer type (73 %) with vascular lesions (24 %) associated with br ain tumours (2 %) or normal-pressure hydrocephalus (1 %). On average, 2 pathologies were associated with Alzheimer's dementia and 3.5 with d ementia cum vascular brain lesions. Repeated evaluation of cognitive p erformance was carried out using Folster's Mini Mental Status (MMS), a global evaluation test. It showed that 18 % of the patients were sign ificantly improved while the other diseases were being treated. The hy pothesis of regressive confusional elements superimposed on dementia i s accepted by the authors as it fits the model of geriatric multipatho logy morbidity. Since there is no specific treatment for most types of dementia, particular attention must be paid to associated diseases li kely to aggravate the clinical expression of dementia.