Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-19T15:34:25.240Z Has data issue: false hasContentIssue false
  • English
  • Français

Mental disorders of geriatric inpatients: symptom characteristics and treatment outcome

Published online by Cambridge University Press:  20 May 2020

Martin Haupt ,
Michaela Jänner  and
Frank Richert
Martin Haupt*
Affiliation:
Practice for Psychiatry and Psychotherapy, Neuro-Centrum Düsseldorf / Klinik und Poliklinik für Psychiatrie und Psychotherapie der Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
Michaela Jänner
Affiliation:
Biometrics, LVR-Klinikum Düsseldorf / Kliniken der Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
Frank Richert
Affiliation:
Geriatric Department, Klinik Elbroich, Verbund Katholischer Kliniken Düsseldorf, Düsseldorf, Germany
*
Correspondence should be addressed to: PD Dr. Martin Haupt, Practice for Psychiatry and Psychotherapy, Neuro-Centrum Düsseldorf/Teaching practice of the Klinik und Poliklinik für Psychiatrie und Psychotherapie, Heinrich-Heine-Universität Düsseldorf, Hohenzollernstr. 1-5, D – 40211 Düsseldorf, Germany. Phone: +0049-211-1691040. Fax: +0049-211-1691041. Email: [email protected].
Get access

Abstract

Objectives:

The aim of this study was to describe neuropsychiatric disorders of geriatric inpatients, to investigate associations of psychopathological symptomatology with clinical variables and to determine its impact on treatment outcome.

Methods:

From January to April 2018, treatment data of geriatric inpatient records were collected retrospectively. Clinical diagnoses of neuropsychiatric disorders, that is, depression, dementia, and delirium, were identified. Clinical correlations were calculated by χ2-tests and t-tests. Confounding variables for determined correlations were ascertained by analyses of variance. Functional measurements (Barthel Index, Timed Up and Go, Tinetti Test, and De Morton Immobility Index) were assessed at start and end of geriatric inpatient treatment.

Results:

The mean age of the included 280 inpatients was 84 years, 71% were female, and the mean duration of treatment was 19.5 days. Twenty-nine percent of cases suffered from dementia, 27% from depression, and 15% from delirium at the time of geriatric treatment onset. Mentally ill inpatients, in addition, presented with a significantly higher number of comorbidities, compared to the group of mentally healthy inpatients. In contrast to the dementia and the delirium group of inpatients, prescription of analgetics was highest among the mentally healthy inpatients and inpatients with depression. Improvement was observed in each of the defined groups, and significant functional differences between all groups were found.

Conclusion:

Neuropsychiatric disorders occur quite often in a geriatric hospital department, especially depression and dementia. Clinical correlations determined in this study suggest a close relationship of mental and somatic disorders in geriatric inpatients. This study further demonstrates that neuropsychiatric disorders in multimorbid, elderly patients do not prevent functional improvement.

Keywords

neuropsychiatric disordersgeriatric hospitalclinical symptomatologytreatment outcomecomorbidities
Type
Original Research Article
Information
International Psychogeriatrics , Volume 33 , Special Issue 3: Issue Theme: Neuropsychiatric Symptoms in Older Adults with Cognitive Disorders , March 2021 , pp. 275 - 283
Copyright
© International Psychogeriatric Association 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bickel, H. et al. (2018). The prevalence of dementia and cognitive impairment in hospitals. Deutsches Ärzteblatt International, 115, 733–740.Google ScholarPubMed
Böhm, K., Tesch-Römer, C. and Ziese, T. (2009). Gesundheit und Krankheit im Alter (Health and Illness in the Elderly). Berlin: Robert-Koch-Institut.Google Scholar
Burckhardt, H. and Burger, M. (2012). Ergebnisse und Prädiktoren der geriatrischen Frührehabilitation im Akutkrankenhaus (Results and Predictors of Early Geriatric Rehabilitation). Zeitschrift für Gerontologie und Geriatrie, 45, 138–145.CrossRefGoogle Scholar
De Morton, N. A. and Lane, K. (2010). Validity and Reliability of the De Morton Mobility Index in the subacute hospital setting in a geriatric evaluation and management population. Journal of Rehabilitation Medicine, 42, 956–961.CrossRefGoogle Scholar
DGPPN/DGN (Deutsche Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde/ Deutsche Gesellschaft für Neurologie). (2010). Diagnose- und Behandlungsleitlinie Demenz (Diagnostic and treatment guidelines of dementia). Berlin: Springer.Google Scholar
Dilling, H. and Freyberger, H. (2013). ICD-10 Klassifikation psychischer störungen. Bern: Huber.Google Scholar
Folstein, M. F., Fostein, S. E. and Hugh, P. R. (1975). Mini-mental-state: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatry Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Fuchs, J., Rabenberg, M. and Scheidt-Nave, C. (2013). Prävalenz ausgewählter muskuloskelettaler Erkrankungen (Prevalence of selected musculoskeletal diseases). Bundesgesundheitsblatt, 56, 678–686.CrossRefGoogle Scholar
Gemidas Pro.(2019). Datenauswertung I. Quartal 2019, from 16.07.2019; 28. August 2019.Google Scholar
Geriatrie Bundesverband. (2016). Weißbuch Geriatrie, Bd. 1, 3. Aufl.: Die Versorgung geriatrischer Patienten. Stuttgart: Kohlhammer.Google Scholar
Hartley, P. et al. (2017). The association between cognitive impairment and functional outcome on hospitalised older patients: a systematic review and meta-analysis. Age Ageing, 46, 559–567.Google ScholarPubMed
Hewer, W. and Thomas, C. (2017). Psychopharmakotherapie bei Demenz und Delir. Zeitschrift für Geriatrie und Gerontologie, 50, 106–114.CrossRefGoogle Scholar
Hofmann, W. (2016). Demenz im Akutkrankenhaus. Der Neurologe Psychiater, 17, 26–30.CrossRefGoogle Scholar
Kondrup, J., Rasmussen, H. H., Hamberg, O., Stanga, Z. and the ad hoc ESPEN Working Group. (2003). Nutritional Risk Screening (NRS): a new method based on an analysis of controlled clinical trials. Clinics Nutrition, 22, 321–336.CrossRefGoogle Scholar
Laird, K. T. et al. (2019). Clinical correlates of resilience factors in geriatric depression. International Psychogeriatrics, 31, 193–202.CrossRefGoogle ScholarPubMed
Mahoney, F. and Barthel, D. (1965). Functional evaluation: the Barthel index. Maryland State Medical Journal, 14, 56–61.Google ScholarPubMed
Mende, A., Riegel, A.-K., Plümer, L., Olotu, C., Goetz, A. E. and Kiefmann, R. (2019). Gebrechliche ältere Patienten (Frail Older Patients). Deutsches Ärzteblatt, 116, 73–82.Google Scholar
Mukadam, N. and Sampson, E. L. (2011). A systematic review of the prevalence, associations and outcomes of dementia in older general hospital inpatients. International Psychogeriatrics, 23, 344–355.CrossRefGoogle ScholarPubMed
Statistical Package for the Social Sciences (SPSS) (2014). Version 22, Armonk, NY, USA: IBM.Google Scholar
Travers, C., Byrne, G., Pachana, N., Klein, K. and Gray, L. (2013). Prospective observational study of dementia and delirium in the acute hospital setting. Internal Medicine Journal, 43, 262–269.CrossRefGoogle ScholarPubMed
Yesavage, J. A. et al. (1982). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatry Research, 39, 37–49.CrossRefGoogle Scholar
Zoremba, N. and Coburn, M. (2019). Delir im Krankenhaus (Delirium in Hospital). Deutsches Ärzteblatt, 116, 101–116.Google Scholar