Background: Various patterns of dementia care have been developed in different settings, depending on the availability of healthcare resources and facilities. The purpose of this study was to examine the epidemiology and characteristics of dementia care at a geriatric clinic, a field that has been subject to little prior evaluation. Methods: A retrospective chart review was undertaken of cohort patients with cognitive impairment who had received a diagnosis and were still on active follow-up at a geriatric clinic. A total of 892 patients were included. In addition, 203 geriatric patients with no cognitive impairment who attended the clinic during the study period were sampled as a control. Results: The main diagnoses of dementia were Alzheimer’s disease (AD) (40.1%), vascular dementia (16.9%), unspecified dementia (16.3%), mixed dementia (9.0%), AD with cerebrovascular disease (8.7%), and Parkinson’s disease dementia (6.1%). Atypical dementia was presented in 3.0% of cases. There were 178 patients with mild cognitive impairment, 20 with vascular cognitive impairment, and 18 with subjective cognitive decline. Other comorbidities were found in 97% of the subjects. Patients with cognitive impairment had a higher total number of other geriatric syndromes and higher percentages for delirium, falls, immobility, loss of appetite, and incontinence. Potentially reversible causes of dementia were found in 11.3% of the cases. Acetylcholinesterase inhibitors were administered to 61%, whereas 23.5% received an NMDA receptor antagonist. The need for a change in the antidementia medication was identified for 10.7% of the subjects; the major cause was adverse drug side effects. Nonpharmacological therapy only was administered to 52.4% of the people with dementia who had behavioral and psychological symptoms. Conclusions: Mixed brain pathologies, comorbidities, and the coexistence of other geriatric syndromes are common at geriatric clinics. Holistic, integrated, and continuous care are needed to improve the outcomes of patients with more complicated comorbidities.
Dement Geriatr Cogn Disord

中文翻译：

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老年痴呆症和认知障碍的特征和现实生活结果

背景：根据医疗资源和设施的可用性，已经在不同的环境中开发了多种痴呆护理模式。这项研究的目的是在老年医学诊所检查痴呆症的流行病学和特征，该领域以前很少进行评估。方法：对接受诊断并仍在老年诊所进行积极随访的队列认知障碍患者进行回顾性图表审查。总共包括892名患者。另外，对203名在研究期间就诊的无认知障碍的老年患者进行了抽样。结果：痴呆的主要诊断是阿尔茨海默氏病（AD）（40.1％），血管性痴呆（16.9％），未指明的痴呆（16.3％），混合性痴呆（9.0％），合并脑血管疾病的AD（8.7％）和帕金森氏病痴呆（6.1％）。非典型性痴呆占3.0％。轻度认知障碍患者178例，血管性认知障碍患者20例，主观认知障碍患者18例。在97％的受试者中发现了其他合并症。认知障碍患者的其他老年性综合征总数更高，total妄，跌倒，行动不便，食欲不振和失禁的百分比更高。在11.3％的病例中发现了潜在的可逆性痴呆原因。乙酰胆碱酯酶抑制剂的使用率为61％，而23.5％则使用了NMDA受体拮抗剂。确定了10.7％的受试者需要更改抗痴呆药物。主要原因是药物不良反应。仅对有行为和心理症状的痴呆患者中的52.4％进行非药物治疗。结论：在老年病诊所中，混合的脑部病理，合并症和其他老年病综合征的共存是常见的。需要整体，综合和连续的护理来改善合并症更为复杂的患者的预后。
Dement Geriatr Cogn Disord