Articles: dementia.
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We report on the prevalence of dementia in Canadians age 85 years and older. The purpose of this study was to determine whether the prevalence of dementia continued to increase in the very old, and to define the types of dementia and their relative proportions in this age group. We collected data as part of the Canadian Study of Health and Aging (1990 to 1992), which consisted of a sample of 1,835 subjects from a population of 283,510 Canadians who were 85 years of age and older residing in the community or in institutions. ⋯ The prevalence of dementia of 23% in the 85- to 89-years sample (n = 1,332) increased to 40% in the 90 to 94 years group (n = 371) and, in the 95 years and older sample (n = 104), reached 58%. Overall, Alzheimer's disease (AD; probable or possible) accounted for 75% of all dementias; a vascular etiology alone accounted for 13% of dementias. The proportion of clinically diagnosed AD cases to vascular dementia cases increased significantly after age 65 and was higher in the 85+ group than in a younger cohort (65 to 84 years).
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Dementia and depression are among the most frequent and disabling conditions in the elderly. The prognosis of depression is similar in young and elderly patients; however, treatment can be more risky in the latter. Incorrect diagnosis of dementia as well as therapeutic relentlessness should be avoided. ⋯ Patients with very mild dementia are often referred for a depression, which is ruled out by careful examination. There is no simple mean to differentiate dementia from depression. The proper way remains to perform a strict clinical, neuropsychological and psychiatric examination.
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Patients of a geriatric hospital (n = 263; 145 women, 118 men) had the task of drawing a clock and indicating a given time by the placements of hands. Errors were classified hierarchically by using a five-category-panel based on defined criteria. Its use as a "first-line" screening test for cognitive disorders in old age was evaluated. ⋯ Sudden onset of cognitive disorder (most commonly confusion) in case of acute disease was discovered by the clock drawing test. Focusing on all patients without apparent cognitive disorder and with normal AMT-result, the subgroup of patients with faultless clock drawings was significantly younger (t = 5.0); p < 0.001). It is suggested to use the clock drawing test in addition to conventional psychometric screening tests because it requires visuospatial skills and conceptual thinking in addition to mere mnestic and verbal qualities.(ABSTRACT TRUNCATED AT 250 WORDS)