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Dementia in Long-term Care Facilities: A Survey of the Ottawa-Carleton Region*

Published online by Cambridge University Press:  29 November 2010

Anne Carswell-Opzoomer ,
John Puxty ,
Martha Teaffe  and
Wikke Walop
Anne Carswell-Opzoomer
Affiliation:
University of Ottawa
John Puxty
Affiliation:
University of Ottawa
Martha Teaffe
Affiliation:
University of Ottawa
Wikke Walop
Affiliation:
University of Ottawa
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Abstract

A census was taken on 26 long-term care facilities in the Ottawa-Carleton Region comprising 3, 825 residents to estimate the point prevalence of cognitive impairment or dementia. Nurses familiar with the residents identified those who had either memory impairment or dementia (according to DSM III criteria). A validation of the data obtained through the census was carried out on a stratified, random sample of residents. The long-term care facilities were stratified by level of care and by size. From each of the three strata, 11 facilities were randomly selected then a 10 per cent random sample with replacement (411 residents) was determined. The validation survey consisted of interviewing residents using two screening instruments, interviewing the nurse using two behavioural instruments and a chart audit. On the census the prevalence for cognitive impairment in the surveyed group was 67 per cent compared to 61 per cent for the whole resident population. The sensitivity and specificity for cognitive impairment was calculated at 84 and 70 per cent respectively. The prevalence of dementia in the surveyed group was 61 per cent compared to a census estimate of 52 per cent for the whole resident population. The overall sensitivity of the census for dementia was 95 per cent and the specificity was 83 per cent. The results indicated that a census undertaken with standardized definitions, by knowledgeable staff directly involved with patient care is a reasonably effective method for estimating the prevalence of persons with dementia in long-term care facilities.

Résumé

Un recensement auprès de 26 établissements de soins prolongés de la Région d'Ottawa-Carleton, pour un total de 3825 bénéficiaires, a été fait afin d'évaluer la prévalence de démence ou de diminution des capacités cognitives dans la population visée. Les personnes présentant de la démence ou des problèmes de mémoire (selon les critères du DSM III) ont été identifiées par leurs infirmières. Un échantillon «stratifié» et aléatoire a été utilisé pour la validation des données. Les établissements de soins prolongés ont été «stratifies» selon le niveau des soins dispensés et leur grandeur. Onze établissements de chacune des trois strates ont été choisis aléatoirement. Ensuite, un échantillon aléatoire de 10 pour cent avec remplacement (411 bénéficiaires) a été déterminé. L'étude de validation s'est faite par: entrevues avec bénéficiaires utilisant deux instruments de dépistage; entrevues avec infirmières utilisant deux outils de fonctionnement et une révision des dossiers. Le recensement démontre une prévalence de 67 pour cent de problèmes cognitifs pour l'échantillon retenu, comparativement à 52 pour cent dans la population totale des bénéficiaires. La sensibilité du recensement pour la démence est de 95 pour cent et sa spécificité, 83 pour cent. Les résultats indiquent qu'un recensement entrepris par du personnel bien informé et directement impliqué avec les bénéficiaires, selon des definitions standardisées, est une méthode raisonnablement efficace d'estimer la prévalence de démence dans les établissements de soins prolongés.

Keywords

PrevalenceDementiaLong-term careCognitive Impairment.Prévalencedémencesoins de longue duréedétérioration cognitive.
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 12 , Issue 3 , Fall/automne 1993 , pp. 360 - 372
Copyright
Copyright © Canadian Association on Gerontology 1993

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References

American Psychiatric Association. (1982). Diagnostic and Statistical Manual of Mental Disorders (DSM – III – R). Washington: American Psychiatric Association.Google Scholar
Anthony, J.C., LeResche, L., Niaz, U., Von Koff, M.R., & Folstein, M.F. (1982). Limits of the mini-mental state as a screening test for dementia and delirium among hospital patients. Psychological Medicine, 12: 397–408.CrossRefGoogle ScholarPubMed
Eastwood, R., & Corbin, S. (1985). Epidemiology of mental disorders in old age. In Arie, T. (Ed.), Recent Advances in Psychogeriatrics. New York: Churchill.Google Scholar
Eastwood, R., Lautenschlaeger, E., & Corbin, S. (1983). A comparison of clinical methods for assessing dementia. Journal of the American Geriatrics Society, 31: 342–347.CrossRefGoogle ScholarPubMed
Folstein, M., Anthony, J.C., Parhad, I., Duffy, B., & Gruenberg, E.M. (1985). The meaning of cognitive impairment in the elderly. Journal of the American Geriatrics Society, 33: 228–235.CrossRefGoogle ScholarPubMed
Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975). “Mini Mental State” a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12: 189–198.CrossRefGoogle ScholarPubMed
Health and Welfare Canada. (1983). Fact Book on Aging in Canada. Ottawa: Minis ter of Supply and Services.Google Scholar
Henderson, A.S., & Jorm, A.F. (1987). Is case-ascertainment of Alzheimer's disease in field surveys practicable? Psychological Medicine, 17: 549–555.CrossRefGoogle ScholarPubMed
Jagger, C, Clarke, M., & Cook, A.J. (1989). Mental and physical health of elderly people: five-year follow-up of a total population. Age and Aging, 18: 77–82.CrossRefGoogle ScholarPubMed
Jorm, A.F., Korten, A.E., & Henderson, A.S. (1987). The prevalence of dementia. A quantitative integration of the literature. Acta Psychiatrica Scandinavia, 76: 465–479.CrossRefGoogle ScholarPubMed
Linn, M.W., & Linn, B.S. (1982). The rapid disability scale 2. Journal of American Geriatrics Society, 30: 378–382.CrossRefGoogle ScholarPubMed
Little, A.G., Hemsely, D.R., & Volans, P.J. (1986). Cognitive ability as a predictor of self-care performance and change in the elderly. International Journal of Geri atric Psychiatry, 1: 107–119.CrossRefGoogle Scholar
Office for Senior Citizens' Affairs. (1986). A New Agenda. Health and Social Service Strategies for Ontario's Seniors. Toronto: Office for Seniors' Affairs.Google Scholar
Reisberg, B., Schneck, M.K., & Ferris, S.H. (1983). The brief cognitive rating scale (BCRS): findings in primary degenerative dementia (PDD). Psychopharmaco-logical Bulletin, 19: 47–50.Google Scholar
Robertson, D., Rockwood, K, & Stole, P. (1989). The prevalence of cognitive impairment in an elderly Canadian population. Acta Psychiatrica Scandinavia, 80: 303–309.CrossRefGoogle Scholar
Schonberg, B.S., Anderson, A.W., & Haerer, A.F. (1985). Severe dementia, preva lence and clinical features in a bi-racial US population. Archives of Neurology, 42: 740–743.CrossRefGoogle Scholar
Schwenger, C.W., & Gross, M.J. (1980). Institutional Care and Institutionalization of Elderly in Canada. In Marshall, V.W. (Ed.), Aging in Canada — Social Perspectives. Don Mills: Fitzhenry and Whiteside.Google Scholar
Sheikh, J.I., & Yesavage, J.A. (1986). Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. In Brink, T.L. (Ed.), Clinical Gerontology: A Guide to Assessment and Intervention. New York: Haworth Press.Google Scholar
Task Force for the Allocation of Health Care Resources. (1984). Health: A Need for Redirection. Ottawa: Canadian Medical Association.Google Scholar
Thai, L.J., Grundman, M., & Golden, R. (1986). Alzheimer's disease: a correlational analysis of the Blessed information-memory-concentration test and the mini-mental state exam. Neurology, 36: 262–264.Google Scholar
Yesavage, J.A., Brink, T.L., Rose, T.L., & Adey, M. (1983). The geriatric depression rating scale comparison with other self report and psychiatric rating scales. In Crook, T., Ferris, S. & Bartus, R. (Eds.), Assessment in Geriatric Psychophar-macology. New Caanan: Mark Powley Assoc Inc.Google Scholar