Diagnostic Failure of Cognitive Impairment in Nursing Home Residents May Lead to Impaired Medical Care
(2019) In Dementia and Geriatric Cognitive Disorders 47(4-6). p.209-218- Abstract
BACKGROUND/OBJECTIVES: Dementia and cognitive impairment are common in nursing homes. Few studies have studied the impact of unnoted cognitive impairment on medical care. This study aimed to estimate the prevalence of diagnostic failure of cognitive impairment in a sample of Swedish nursing home residents and to analyze whether diagnostic failure was associated with impaired medical care.
METHOD: A total of 428 nursing home residents were investigated during 2008-2011. Subjects without dementia diagnosis were grouped by result of the Mini Mental State Examination (MMSE), where subjects with <24 points formed a possible dementia group and the remaining subjects a control group. A third group consisted of subjects with diagnosed... (More)
BACKGROUND/OBJECTIVES: Dementia and cognitive impairment are common in nursing homes. Few studies have studied the impact of unnoted cognitive impairment on medical care. This study aimed to estimate the prevalence of diagnostic failure of cognitive impairment in a sample of Swedish nursing home residents and to analyze whether diagnostic failure was associated with impaired medical care.
METHOD: A total of 428 nursing home residents were investigated during 2008-2011. Subjects without dementia diagnosis were grouped by result of the Mini Mental State Examination (MMSE), where subjects with <24 points formed a possible dementia group and the remaining subjects a control group. A third group consisted of subjects with diagnosed dementia. These three groups were compared according to baseline data, laboratory findings, drug use, and mortality.
RESULTS: Dementia was previously diagnosed in 181 subjects (42%). Among subjects without a dementia diagnosis, 72% were cognitively impaired with possible dementia (MMSE <24). These subjects were significantly older, did not get anti-dementia treatment, and had higher levels of brain natriuretic peptide compared to the diagnosed dementia group, but the risks of malnutrition and pressure ulcers were similar to the dementia group.
CONCLUSIONS: Unnoted cognitive impairment is common in nursing home residents and may conceal other potentially treatable conditions such as heart failure. The results highlight a need to pay increased attention to cognitive impairment among nursing home residents.
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- author
- Westerlind, Björn ; Östgren, Carl Johan LU ; Midlöv, Patrik LU and Marcusson, Jan
- organization
- publishing date
- 2019-07-03
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Dementia and Geriatric Cognitive Disorders
- volume
- 47
- issue
- 4-6
- pages
- 10 pages
- publisher
- Karger
- external identifiers
-
- pmid:31269489
- scopus:85068515589
- ISSN
- 1420-8008
- DOI
- 10.1159/000499671
- language
- English
- LU publication?
- yes
- additional info
- © 2019 S. Karger AG, Basel.
- id
- a50140ed-8c49-4618-858e-e43c0c4304cc
- date added to LUP
- 2019-07-05 22:21:58
- date last changed
- 2024-09-04 05:14:01
@article{a50140ed-8c49-4618-858e-e43c0c4304cc, abstract = {{<p>BACKGROUND/OBJECTIVES: Dementia and cognitive impairment are common in nursing homes. Few studies have studied the impact of unnoted cognitive impairment on medical care. This study aimed to estimate the prevalence of diagnostic failure of cognitive impairment in a sample of Swedish nursing home residents and to analyze whether diagnostic failure was associated with impaired medical care.</p><p>METHOD: A total of 428 nursing home residents were investigated during 2008-2011. Subjects without dementia diagnosis were grouped by result of the Mini Mental State Examination (MMSE), where subjects with <24 points formed a possible dementia group and the remaining subjects a control group. A third group consisted of subjects with diagnosed dementia. These three groups were compared according to baseline data, laboratory findings, drug use, and mortality.</p><p>RESULTS: Dementia was previously diagnosed in 181 subjects (42%). Among subjects without a dementia diagnosis, 72% were cognitively impaired with possible dementia (MMSE <24). These subjects were significantly older, did not get anti-dementia treatment, and had higher levels of brain natriuretic peptide compared to the diagnosed dementia group, but the risks of malnutrition and pressure ulcers were similar to the dementia group.</p><p>CONCLUSIONS: Unnoted cognitive impairment is common in nursing home residents and may conceal other potentially treatable conditions such as heart failure. The results highlight a need to pay increased attention to cognitive impairment among nursing home residents.</p>}}, author = {{Westerlind, Björn and Östgren, Carl Johan and Midlöv, Patrik and Marcusson, Jan}}, issn = {{1420-8008}}, language = {{eng}}, month = {{07}}, number = {{4-6}}, pages = {{209--218}}, publisher = {{Karger}}, series = {{Dementia and Geriatric Cognitive Disorders}}, title = {{Diagnostic Failure of Cognitive Impairment in Nursing Home Residents May Lead to Impaired Medical Care}}, url = {{http://dx.doi.org/10.1159/000499671}}, doi = {{10.1159/000499671}}, volume = {{47}}, year = {{2019}}, }