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Diagnostic Failure of Cognitive Impairment in Nursing Home Residents May Lead to Impaired Medical Care

Westerlind, Björn; Östgren, Carl Johan LU ; Midlöv, Patrik LU and Marcusson, Jan (2019) In Dementia and Geriatric Cognitive Disorders
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
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Dementia and Geriatric Cognitive Disorders
pages
10 pages
publisher
Karger
external identifiers
  • scopus:85068515589
ISSN
1420-8008
DOI
10.1159/000499671
language
English
LU publication?
yes
id
a50140ed-8c49-4618-858e-e43c0c4304cc
date added to LUP
2019-07-05 22:21:58
date last changed
2019-08-14 04:41:30
@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 &lt;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 &lt;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},
  pages        = {10},
  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},
  year         = {2019},
}