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Behavioural and psychiatric symptoms in people with dementia admitted to the acute hospital: prospective cohort study

By: Publication details: 2014Uniform titles:
  • British Journal of Psychiatry
Online resources: Summary: <p style="margin: 0px 0px 0.5em; line-height: 1.538em; font-size: 1.04em; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">Dementia is common in older people admitted to acute hospitals. There are concerns about the quality of care they receive. Behavioural and&nbsp;<span class="highlight">psychiatric</span>&nbsp;symptoms of dementia (BPSD) seem to be particularly challenging for hospital staff. AIMS To define the prevalence of BPSD and explore their clinical associations.</span></p><h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">METHOD:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 1.538em; font-size: 1.04em; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">Longitudinal cohort study of 230 people with dementia, aged over 70, admitted to hospital for acute medical illness, and assessed for BPSD at admission and every 4 (± 1) days until discharge. Other measures included length of stay, care quality indicators, adverse events and mortality.</span></p><h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">RESULTS:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 1.538em; font-size: 1.04em; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">Participants were very impaired; 46% at Functional Assessment Staging Scale (FAST) stage 6d or above (doubly incontinent), 75% had BPSD, and 43% had some BPSD that were moderately/severely troubling to staff. Most common were aggression (57%), activity disturbance (44%), sleep disturbance (42%) and anxiety (35%).</span></p><h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">CONCLUSIONS:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 1.538em; font-size: 1.04em; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">We found that BPSD are very common in older people admitted to an acute hospital. Patients and staff would benefit from more specialist&nbsp;<span class="highlight">psychiatric</span>&nbsp;support.</span></p>
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&lt;p style="margin: 0px 0px 0.5em; line-height: 1.538em; font-size: 1.04em; font-family: arial, helvetica, clean, sans-serif;"&gt;&lt;span style="font-size: 10pt;"&gt;Dementia is common in older people admitted to acute hospitals. There are concerns about the quality of care they receive. Behavioural and&amp;nbsp;&lt;span class="highlight"&gt;psychiatric&lt;/span&gt;&amp;nbsp;symptoms of dementia (BPSD) seem to be particularly challenging for hospital staff. AIMS To define the prevalence of BPSD and explore their clinical associations.&lt;/span&gt;&lt;/p&gt;&lt;h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;"&gt;&lt;span style="font-size: 10pt;"&gt;METHOD:&lt;/span&gt;&lt;/h4&gt;&lt;p style="margin: 0px 0px 0.5em; line-height: 1.538em; font-size: 1.04em; font-family: arial, helvetica, clean, sans-serif;"&gt;&lt;span style="font-size: 10pt;"&gt;Longitudinal cohort study of 230 people with dementia, aged over 70, admitted to hospital for acute medical illness, and assessed for BPSD at admission and every 4 (± 1) days until discharge. Other measures included length of stay, care quality indicators, adverse events and mortality.&lt;/span&gt;&lt;/p&gt;&lt;h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;"&gt;&lt;span style="font-size: 10pt;"&gt;RESULTS:&lt;/span&gt;&lt;/h4&gt;&lt;p style="margin: 0px 0px 0.5em; line-height: 1.538em; font-size: 1.04em; font-family: arial, helvetica, clean, sans-serif;"&gt;&lt;span style="font-size: 10pt;"&gt;Participants were very impaired; 46% at Functional Assessment Staging Scale (FAST) stage 6d or above (doubly incontinent), 75% had BPSD, and 43% had some BPSD that were moderately/severely troubling to staff. Most common were aggression (57%), activity disturbance (44%), sleep disturbance (42%) and anxiety (35%).&lt;/span&gt;&lt;/p&gt;&lt;h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;"&gt;&lt;span style="font-size: 10pt;"&gt;CONCLUSIONS:&lt;/span&gt;&lt;/h4&gt;&lt;p style="margin: 0px 0px 0.5em; line-height: 1.538em; font-size: 1.04em; font-family: arial, helvetica, clean, sans-serif;"&gt;&lt;span style="font-size: 10pt;"&gt;We found that BPSD are very common in older people admitted to an acute hospital. Patients and staff would benefit from more specialist&amp;nbsp;&lt;span class="highlight"&gt;psychiatric&lt;/span&gt;&amp;nbsp;support.&lt;/span&gt;&lt;/p&gt;

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