Tag Archives: Hospital Care

How accurate are informant tools when used to diagnose dementia in hospitalised older people with delirium?

Dementia test

A recently published study has investigated the diagnostic test accuracy of two informant tools when used to diagnose dementia in patients with delirium.

It is common for older hospital patients to have both dementia and delirium; the latter is often undiagnosed as the delirium interferes with the use of cognitive testing for diagnosing dementia.

The study cites the need for new tests given the confounding effect of delirium.
The tools tested were the IQCODE-SF and the AD8 (when used for diagnosing DSM-IV dementia).

As part of the study, on admission to hospital, people aged over 70 were assessed for the presence of dementia using the short form of the Informant Questionnaire of Cognitive Decline in the Elderly (IQCODE-SF) and Alzheimer’s Disease 8 (AD8).

The conclusions drawn from the results were that the IQCODE-SF and AD8 are sensitive and specific tools, able to detect prior dementia in older people with delirium. The authors suggest that the routine use of either tool in practice could improve the recognition and subsequent management of those with dementia.
Jackson, T. A., MacLullich, A. M. J., Gladman, J. R. F., Lord, J. M., and Sheehan, B. (2016) ‘Diagnostic test accuracy of informant-based tools to diagnose dementia in older hospital patients with delirium: a prospective cohort study’, Age and Ageing, pp. 45: 505-511.

Focus on dementia – January 2016

The Health and Social Care Information Centre (HSCIC) has published statistics on dementia. These statistics focus on five strategic aspects of dementia care:

  1. Prevention.
  2. Diagnosis.
  3. Post-Diagnostic Support.
  4. Living Well With Dementia.
  5. Mortality Associated With Dementia.

Preventing well

  • There is evidence that some factors – particularly around cardiovascular risk – can impact on the risk of developing dementia. To have their greatest impact on reducing dementia risk these factors should be controlled throughout middle age (45-64).

Diagnosing well

  • Diagnosed prevalence increased from 643 per 100,000 in April 2014 to 755 per 100,000 in December 2015, which is 423,000 diagnoses out of 56.0m registered  patients.

Supporting well

  • 39 per cent of carers spent 100 or more hours each week looking after or caring for a person with dementia, with 52 per cent spending 50 hours or more per week.

Living well

  • Looking at all records from April 2012 to March 2015;
    • The median time for progression between ‘moderate need’ and ‘high need’ is 3 years and 2 months.
    • The median time for progression between ‘high need’ and ‘high physical need of engagement’ is 2 years and 9 months.

Dementia and mortality

  • The results of the survival analysis provide a median survival time of 3 years 6 months, from when patients are first assessed as having ‘cognitive impairment or dementia at moderate need’.

For more information visit the HSCIC website.

Click here to read the full report.

focus on dementia.png

Variation of hospital care quality for dementia

The Alzheimer’s Society is launching a campaign to tackle what it calls an ‘unacceptable national variation in the quality of hospital care across England’. An investigation has revealed that an alarming number of people with dementia are falling while in hospital, being discharged during the night or are left in hospital despite their treatment having been completed.

The Alzheimer’s Society has published the findings of its investigation which was comprised of FOI requests to NHS Trusts in England and a significant survey of people receiving dementia care in hospitals.

For more information about the campaign, Fix Dementia Care, and relevant research, visit the Alzheimer’s Society web site.

 

Alzheimer’s Society (2016) Shocking variation of hospital care for people with dementia exposed. Available at: https://www.alzheimers.org.uk/site/scripts/news_article.php?newsID=2537