European Psychiatry - Volume 33 - March 2016

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S222 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW311
Dementia in acutely-ill medical
elderly patients
P. Sá Esteves ∗ Loureiro , E. Albuquerque , F. Vieira , L. Lagarto ,
S. Neves , J. Cerejeira
Centro Hospitalar e Universitário de Coimbra, Psychiatry, Coimbra,
Portugal
∗ Corresponding author.
Introduction Dementia is one of the leading causes of disability
and burden in Western countries. In Portugal, there is a lack of
data regarding dementia prevalence inhospitalized elderly patients
and factors associated with in-hospital adverse outcomes of these
patients.
Objectives Determine dementia prevalence in acutely-ill medical
hospitalized elderly patients and its impact in health outcomes.
Methods All male patients (> 65 years) admitted to a medical
ward (> 48 h) between 1.03.2015 to 31.08.2015 were included
in the study. Patients were excluded if unable to be assessed
due to sensorial deficits, communication problems or severity of
the acute medical condition. Baseline evaluation included socio-
demographic variables, RASS, NPI, Barthel Index and Confusion
Assessment Method.
Results The final sample consisted of 270 male subjects with a
mean age of 80.9 years, 116 (43%) having prior dementia. Dementia
patients were significantly older (83.5 vs 78.9; P < 0.001) and had
lower values of Barthel Index (dementia: 34.8 vs non-dementia:
85.8; P < 0.001). Mortality rate (9,3%) and length of hospitalization
(11.2 days) were similar between groups (12.1 vs 7.1; P = 0.204 and
11.9 vs 10.6; P = 0.218, respectively). Patients with dementia had
higher rates of all neuropsychiatric symptoms except depression,
anxiety and mood elation. The level of consciousness (measured
by RASS) was impaired in 50% of patients with dementia, which
was significantly higher than in non-demented subjects (12.3%;
P < 0.001). Delirium rates were 29.5% in dementia compared with
7.1% in controls ( P < 0.001).
Conclusions There is a high prevalence of dementia and an appre-
ciable rate of delirium among these patients.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW312
Depression and mild cognitive
impairment – Comorbidity and/or
continuum?
G. Sobreira ∗, M.A. Aleixo , C. Moreia , J. Oliveira
1 Centro Hospitalar Psiquiátrico de Lisboa, First Psychotic Episode
Unit, Lisboa, Portugal
2 Centro Hospitalar Psiquiátrico de Lisboa, Schizophrenia and
Schizoaffective Disorders Unit, Lisboa, Portugal
3 Centro Hospitalar Psiquiátrico de Lisboa, Neuropsychiatry and
Dementia Unit, Lisboa, Portugal
∗ Corresponding author.
Introduction Depression andmild cognitive impairment are com-
mon among the elderly. Half the patients with late-life depression
also present some degree of cognitive decline, making the distinc-
tion between these conditions difficult.
Objectives To conduct a database review in order to understand
the relationship between these entities, and treatment approaches.
Aims To create and implement clinical guidelines at our insti-
tution, to evaluate and treat elderly patients presenting with
depression and mild cognitive impairment.
Methods A PubMed database search using as keywords “late life
depression”, “depression”; “cognitive impairment”; “mild cognitive
impairment” and “dementia” between the year 2008 and 2015.
Results Late-life depression and cognitive impairment are fre-
quent among the elderly (10–20%). Depression is also common in
the early stages of dementia decreasing as the cognitive decline
progresses. The causal relationship between these entities is not
well understood and some authors advocate a multifactorial model
(genetic risk factors; neuroendocrine changes; vascular risk factors)
and the cognitive impairment of said changes is dependent on the
individual’s cognitive reserve. Regarding treatment of depression
in patients with cognitive impairment, most authors advocate a
stepped approach with watchful waiting and then, if symptoms
persist, the introduction of pharmacotherapy and psychosocial
intervention.
Conclusions The relationship between cognitive impairment and
depression is still not clear and probably multifactorial. The diag-
nosis of depressive symptoms in patients with severe cognitive
impairment can be difficult and most forms of pharmacological
treatment in this population are not beneficial, making it important
to carefully evaluate the benefits of introducing new medication.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW313
Anosognosia in dementia – Relevance
for clinical-practice in a memory
clinic
S. Verhülsdonk∗, B. Höft , T. Supprian , C. Lange-Asschenfeldt
Heinrich Heine University, Department of Psychiatry and
Psychotherapy, Düsseldorf, Germany
∗ Corresponding author.
Introduction Anosognosia is a common symptom in patientswith
dementia, although data on prevalence vary widely. It is associated
with decreased compliance to medical diagnosis and treatment.
The rejection of assistance challenges professionals aswell as caring
relatives.
Objectives Anosognosia increaseswith progression of disease but
is also found in early stages. The underlying mechanisms are not
completely understood; past studies described an association with
executive dysfunction.
Aims Our study aims to identify the frequency of anosognosia in
our memory clinic.
Methods We evaluated disease awareness using the Clinical
Insight Rating Scale in 124 patients presenting with diagnosis of
Alzheimer’s disease in our memory clinic. We correlated the degree
of awareness with standardized cognitive, affective, and functional
parameters.
Results One hundred and fourteen patients (90.9%) showed
decreased awareness, in 51.7% of our sample awareness was seri-
ously impaired or even entirely lacking. In accordance with the
literature, anosognosia correlated significantly with the result of
the Mini-Mental-Staus-Examination as indicator of global cog-
nitive functioning (r = −0.291, P < 0.05) and with the need for
assistance in everyday-life (r= .364, P < 0.05). We found no corre-
lation with depressive symptoms or age.
Conclusion The phenomenon of anosognosia is frequent in the
setting of amemory clinic andhas special impact on clinical practice
as it is well correlated with executive functioning and global cogni-
tion and, thus, is a relevant factor for the initiation of medical care
for patients with dementia.