Table of Contents Table of Contents
Previous Page  226 / 812 Next Page
Information
Show Menu
Previous Page 226 / 812 Next Page
Page Background

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.428

EW311

Dementia in acutely-ill medical

elderly patients

P. Sá Esteves

, D.

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.429

EW312

Depression and mild cognitive

impairment – Comorbidity and/or

continuum?

G. Sobreira

1 ,

, M.A. Aleixo

1

, C. Moreia

2

, J. Oliveira

3

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.430

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.