Prevalence of the dementia syndrome in the oldest residents of a somatic nursing home

OBJECTIVE: To estimate the prevalence of dementia among subjects of 85 years and over residing in a somatic nursing home. DESIGN: A two-phase design with the mini-mental state examination (MMSE) in the screening phase and the geriatric mental state schedule (GMS) in the diagnostic phase. SETTING: Three somatic nursing homes in Leiden. SUBJECTS: All subjects aged 85 years and over residing in one of the three nursing homes on December 1, 1986. First phase participation rate was 75%; second phase participation rate was 88%. MAIN OUTCOME MEASURE: DSM-III diagnosis of dementia without further specification of the aetiology of the dementia. RESULTS: An overall prevalence of 54% (95% CI: 43-66%) was found. This included 32% mild dementia, 9% moderate and 13% severe dementia. CONCLUSION: Dementia was found to be the most prevalent disorder among somatic nursing home residents aged 85 years and over. The shortage of psychogeriatric nursing home beds may have contributed to this high prevalence of dementia. However, the relatively large number of mild cases, which are usually not listed for admission to a psychogeriatric nursing home, indicates that the combination of a beginning dementia with physical impairment led to admission to a somatic nursing home. Considering the growth of the oldest part of the population it is to be expected that the prevalence of dementia will remain high among the oldest residents of somatic nursing homes.