Prevalence and therapeutic management of dementia in nursing homes in Asturias (Spain)

OBJECTIVES: To study the prevalence of cognitive decline and dementia in the residential environment, the pharmacological and non-pharmacological treatments used, and the possible existence of undiagnosed dementia. MATERIAL AND METHODS: We performed a cross-sectional epidemiological study in a population of 215 elderly persons institutionalized in October 2007 in three nursing homes in Asturias. Socio-demographic, clinical, functional and mental variables were collected through a predefined study protocol. RESULTS: A total of 215 elderly individuals were included in the study (mean +/- standard deviation [SD] 81.2+/-10.2 years, 70.2% women). Barthel Index scores were 50.63+/-37.43, Mini-Mental State Examination (MMSE) scores were 14.71+/-9.73 and Geriatric Depression Scale (GDS) scores were 3.63+/-3.74. Dementia had been diagnosed in 34.4%, the most prevalent cause being Alzheimer's disease (20.9%). Among patients diagnosed with dementia, 45.9% received specific pharmacological treatment for Alzheimer's disease. Among elderly residents who had attended school, 77.8% had MMSE scores below 24 and 32.9% were diagnosed with dementia. Among individuals that had not attended school, 75% had MMSE scores below 18 and 39.6% were diagnosed with dementia. CONCLUSIONS: In our study population, approximately 76% of nursing home residents showed some degree of cognitive decline, 1 out of 3 residents had been diagnosed with dementia and about half were receiving specific pharmacological treatment. The results show that approximately 40% of elderly individuals admitted to nursing homes with cognitive impairment lack a clear diagnosis of the syndrome or its cause.