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Patients with Korsakoff syndrome in nursing homes: characteristics, comorbidity, and use of psychotropic drugs

Published online by Cambridge University Press:  09 September 2013

Ineke J. Gerridzen  and
M. Anne Goossensen
Ineke J. Gerridzen*
Affiliation:
Atlant Care Group, Nursing Home Markenhof, Beekbergen, the Netherlands
M. Anne Goossensen
Affiliation:
University of Humanistic Studies, Utrecht, the Netherlands
*
Correspondence should be addressed to: Ineke J. Gerridzen, MD, Elderly Care Physician, Atlant Care Group, Nursing Home Markenhof, Kuiltjesweg 1, 7361 TC Beekbergen, the Netherlands. Phone: +31-55-5067200; +31-6-51263852; Fax: +31-55-5067201. Email: [email protected].
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Abstract

Background:

Very limited literature exists on the care and course of patients with Korsakoff syndrome (KS) living in long-term care facilities (LTCFs). Even less literature can be found on the pharmacological treatment of behavioral symptoms of KS. The purpose of the present study was to describe baseline characteristics, comorbidity, and the use of psychotropic drugs in institutionalized patients with KS.

Methods:

In this cross-sectional descriptive study, 556 patients were included living in ten specialized care units in Dutch nursing homes. Data were collected by means of a retrospective chart review.

Results:

The majority of patients were men (75%) and single (78%) with a mean age on admission of 56.7 years (SD 8.9, range 29.8–85.3). Mean length of stay was 6.0 years (SD 5.4, range 0.2–33.3). Sixty-eight percent of patients suffered from at least one somatic disease and 66% from at least one extra psychiatric disorder. One or more psychotropic drugs were prescribed to 71% of patients with a great variation in prescription patterns between the different nursing homes.

Conclusion:

Patients with KS depending on long-term care usually have comorbidity in more than one domain (somatic and psychiatric). The indications for prescribing psychotropic drugs are in many cases unclear and it seems probable that they are often given to manage challenging behavior. Longitudinal studies on the evidence for this prescription behavior and possible alternatives are recommended.

Keywords

Korsakoff syndromealcohol-related dementialong-term carenursing homescomorbiditypsychotropic drugsbehavioral symptoms
Type
Research Article
Information
International Psychogeriatrics , Volume 26 , Issue 1 , January 2014 , pp. 115 - 121
Copyright
Copyright © International Psychogeriatric Association 2013 

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References

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn.Washington, DC: American Psychiatric Association.Google Scholar
Ballard, C. and Howard, R. (2006). Neuroleptic drugs in dementia: benefits and harm. Nature Reviews Neuroscience, 7, 492–500.CrossRefGoogle ScholarPubMed
Blansjaar, B. A., Horjus, M. C. and Nijhuis, H. G. (1987). Prevalence of the Korsakoff syndrome in The Hague, The Netherlands. Acta Psychiatrica Scandinavica, 75, 604–607.CrossRefGoogle ScholarPubMed
Draper, B., Karmel, R., Gibson, D., Peut, A. and Anderson, P. (2011). Alcohol-related cognitive impairment in New South Wales hospital patients aged 50 years and over. Australian and New Zealand Journal of Psychiatry, 45, 985–992.CrossRefGoogle ScholarPubMed
Eggermont, L. H., de Vries, K. and Scherder, E. J. (2009). Psychotropic medication use and cognition in institutionalized older adults with mild to moderate dementia. International Psychogeriatrics, 21, 286–294.CrossRefGoogle ScholarPubMed
Galvin, R., Brathen, G., Ivashynka, A., Hillbom, M., Tanasescu, R. and Leone, M. A. (2010). EFNS guidelines for diagnosis, therapy and prevention of Wernicke encephalopathy. European Journal of Neurology, 17, 1408–1418.CrossRefGoogle ScholarPubMed
Gobert, M. and D'Hoore, W. (2005). Prevalence of psychotropic drug use in nursing homes for the aged in Quebec and in the French-speaking area of Switzerland. International Journal of Geriatric Psychiatry, 20, 712–721.CrossRefGoogle ScholarPubMed
Gupta, S. and Warner, J. (2008). Alcohol-related dementia: a 21st-century silent epidemic? British Journal of Psychiatry, 193, 351–353.CrossRefGoogle ScholarPubMed
Harper, C., Gold, J., Rodriguez, M. and Perdices, M. (1989). The prevalence of the Wernicke-Korsakoff syndrome in Sydney, Australia: a prospective necropsy study. Journal of Neurology, Neurosurgery & Psychiatry, 52, 282–285.CrossRefGoogle Scholar
Jauhar, S. and Smith, I. D. (2009). Alcohol-related brain damage: not a silent epidemic. British Journal of Psychiatry, 194, 287–288; author reply 288.CrossRefGoogle Scholar
Kessler, R. C. (2004). The epidemiology of dual diagnosis. Biological Psychiatry, 56, 730–737.CrossRefGoogle ScholarPubMed
Kleijer, B. C.et al. (2009). The course of behavioral problems in elderly nursing home patients with dementia when treated with antipsychotics. International Psychogeriatrics, 21, 931–940.CrossRefGoogle ScholarPubMed
Kopelman, M. D. (1995). The Korsakoff syndrome. British Journal of Psychiatry, 166, 154–173.CrossRefGoogle ScholarPubMed
Kopelman, M. D., Thomson, A. D., Guerrini, I. and Marshall, E. J. (2009). The Korsakoff syndrome: clinical aspects, psychology and treatment. Alcohol & Alcoholism, 44, 148–154.CrossRefGoogle ScholarPubMed
Kranzler, H. R. and Rosenthal, R. N. (2003). Dual diagnosis: alcoholism and co-morbid psychiatric disorders. American Journal on Addictions, 12 (Suppl. 1), S26–40.CrossRefGoogle ScholarPubMed
Lovheim, H., Sandman, P. O., Kallin, K., Karlsson, S. and Gustafson, Y. (2006). Relationship between antipsychotic drug use and behavioral and psychological symptoms of dementia in old people with cognitive impairment living in geriatric care. International Psychogeriatrics, 18, 713–726.CrossRefGoogle ScholarPubMed
Nijk, R. M., Zuidema, S. U. and Koopmans, R. T. (2009). Prevalence and correlates of psychotropic drug use in Dutch nursing-home patients with dementia. International Psychogeriatrics, 21, 485–493.CrossRefGoogle ScholarPubMed
Oort, R. V. and Kessels, R. P. C. (2009). Executive dysfunction in Korsakoff's syndrome: time to revise the DSM criteria for alcohol-induced persisting amnestic disorder? International Journal of Psychiatry in Clinical Practice, 13, 78–81.CrossRefGoogle ScholarPubMed
Oslin, D., Atkinson, R. M., Smith, D. M. and Hendrie, H. (1998). Alcohol related dementia: proposed clinical criteria. International Journal of Geriatric Psychiatry, 13, 203–212.3.0.CO;2-B>CrossRefGoogle ScholarPubMed
Petrakis, I. L., Gonzalez, G., Rosenheck, R. and Krystal, J. H. (2002). Comorbidity of alcoholism and psychiatric disorders. An overview. Alcohol Research and Health, 26, 81–89.Google Scholar
Pitkala, K. H., Laurila, J. V., Strandberg, T. E. and Tilvis, R. S. (2004). Behavioral symptoms and the administration of psychotropic drugs to aged patients with dementia in nursing homes and in acute geriatric wards. International Psychogeriatrics, 16, 61–74.CrossRefGoogle ScholarPubMed
Schepers, J. P., Koopmans, R. T. and Bor, J. H. (2000). [Patients with Korsakoff's syndrome in a nursing home: characteristics and comorbidity]. Tijdschrift voor Gerontologie en Geriatrie, 31, 113–118.Google Scholar
Schneider, L. S., Dagerman, K. and Insel, P. S. (2006). Efficacy and adverse effects of atypical antipsychotics for dementia: meta-analysis of randomized, placebo-controlled trials. American Journal of Geriatric Psychiatry, 14, 191–210.CrossRefGoogle ScholarPubMed
Selbaek, G., Kirkevold, O. and Engedal, K. (2007). The prevalence of psychiatric symptoms and behavioural disturbances and the use of psychotropic drugs in Norwegian nursing homes. International Journal of Geriatric Psychiatry, 22, 843–849.CrossRefGoogle ScholarPubMed
Sink, K. M., Holden, K. F. and Yaffe, K. (2005). Pharmacological treatment of neuropsychiatric symptoms of dementia: a review of the evidence. JAMA, 293, 596–608.CrossRefGoogle ScholarPubMed
Victor, M. (1994). Alcoholic dementia. Canadian Journal of Neurological Sciences, 21, 88–99.CrossRefGoogle ScholarPubMed
Wetzels, R. B., Zuidema, S. U., de Jonghe, J. F., Verhey, F. R. and Koopmans, R. T. (2011). Prescribing pattern of psychotropic drugs in nursing home residents with dementia. International Psychogeriatrics, 23, 1249–1259.CrossRefGoogle ScholarPubMed
Wijnia, J. W., van de Wetering, B. J., Zwart, E., Nieuwenhuis, K. G. and Goossensen, M. A. (2012). Evolution of Wernicke-Korsakoff syndrome in self-neglecting alcoholics: preliminary results of relation with Wernicke-delirium and diabetes mellitus. American Journal on Addictions, 21, 104–110.CrossRefGoogle ScholarPubMed
Zahr, N. M., Kaufman, K. L. and Harper, C. G. (2011). Clinical and pathological features of alcohol-related brain damage. Nature Reviews Neurology, 7, 284–294.CrossRefGoogle ScholarPubMed
Zuidema, S. U., Derksen, E., Verhey, F. R. and Koopmans, R. T. (2007). Prevalence of neuropsychiatric symptoms in a large sample of Dutch nursing home patients with dementia. International Journal of Geriatric Psychiatry, 22, 632–638.CrossRefGoogle Scholar