Socio-demographic characteristics and disability in patients with dementia

Abstract: Dementia is a neuropsychiatric syndrome that is deteriorating with age. Social and occupational functionality of dementia patients are usually impaired significantly. In this study, we analyzed 65 dementia patients. We found that 90.8% of people with dementia did not use any drugs. Disability ratios of dementia types were mild 26.2%, mild to moderate 20%, moderate 29.2%, severe 9.2%, and unspecified 15.4%. Dementia is an insidious and progressive syndrome which causes the loss of cognitive ability.

INTRODUCTION: Dementia is a neuropsychiatric syndrome that is deteriorating with age. A study found that people with dementia represent 5% of the population older than 65 years and 40% of those older than 85 years1 . Dementia may damage mental functions and result in behavioral problems, conducing to a lower quality of life. According to the authorized institutions in Turkey, disability rates of patients with dementia should be classified according to their functionality. These rates defined as follows: mild 25%, mild to moderate 50%, moderate 70%, severe dementia 90%2 . The aim of our study was to investigate individuals older than 65 years regarding sociodemographic characteristics and dementia, seen at the medical board of Dicle University in the years 2013 and 2014, Further, we evaluated whether they were using drugs for dementia and the rates of disability.

MATERIALS AND METHODS: We analyzed 402 subjects older than 65 years who applied to the medical board in Dicle medical faculty in the years 2013 and 2014. Subsequently, researchers investigated the medical records of Dicle University hospital for the diagnosis of dementia, retrospectively. Eventually, we found that 65 of the 402 persons were diagnosed with dementia. These patients were compared in terms of the age, gender, ratio of disability, use of pharmacologic agents and severity of disability.

RESULTS: We found 55% (n=36) males and 45% (n=29) females in all dementia patients (n=65). These patients had a mean age of 80.1years, but non dementia patients (n=337) had a mean age of 72.1years. Also, 64.6% (n=42) of dementia patients were evaluated as severely disabled. Six (9.2%) of 65 dementia patients used pharmacologic agents for the symptoms of dementia. Four of 6 patients among the severely disabled used acetylcholinesterase inhibitors such as donepezil, one of 6 patients used N-methyl-D-aspartate (NMDA) receptor blockers such as memantine, and one more patient was using donepezil plus memantine. Disability ratio of the dementia patients were mild 26.2% (n=17), mild to moderate 20% (n=13), moderate 29.2% (n=19), severe 9.2% (n=6) and unspecified 15.4% (n=10).

DISCUSSION: Dementia is a neuropsychiatric disorder characterized by insidious and progressive features. It may become more frequent with age. In our study, we found that the mean age of dementia patients was higher than the age of those not diagnosed with dementia. In dementia, neural structures in the central nervous system are damaged, affecting various cognitive domains. For this reason, activities of life as well as social and occupational functionality of dementia patients is significantly damaged3 . At the medical board of Dicle University, 64.6% of all dementia patients were found to meet the criteria for disability. These patients ultimately lose the ability to perform daily tasks. For this reason, these patients cannot continue to lead their lives independently. Dementia also affects family caregivers. Given the progressive and terminal nature of dementia, the patients and their caregivers cannot distinguish between senility and cognitive impairments. Unfortunately, we found that 90.8% of people with dementia did not use any drugs for their complaints.

CONCLUSION: Dementia is an insidious and progressive syndrome causing the loss of cognitive ability. It may get worse with age. Therefore, all geriatric patients should be evaluated by the physicians with regard to dementia, even if they are consulting for reasons other than dementia. It should be kept in mind that patients admitted with complaints of aging must be examined by the physicians for dementia to prevent the progression of disease and reduce the loss of ability. We conclude that dementia is associated with many impairments for the quality of life and possibly results in severe disability.