Assessment of Older People's Health and Social Care Needs and ...

The organic illnesses can be divided into two categories, dementia and acute confusional states. Themost commurl causes of dementia are Alzheimer's dementia, Vascular dementia and Lewy bodydementia. With dementia, it is important to diagnose the type of dementia because there aredifferent treatments and advice available for the individuals concerned. Factors seen in peoplesuffering from dementia include memory loss, language impairment, disorientation, change inpersonality, self-neglect and behaviour which is out of character.Acute confusional states are caused by an underlying medical condition or, perhaps, by medicationand require full medical investigation.Prevalence of DiagnosesAs a consultant in old age psychiatry, my caseload is divided into two. Fifty percent of patients havedementia with associated behavioural or psychiatric problems. The other 50 percent have functionalillnesses, mainly depression. The prevalence of the various diagnoses that we see is shown here (seeTable 1). The rates are per 10,000 of the population and there is broad similarity between the Irishand international data.Table 1: Prevalence of DiagnosesDiagnosisDementiaDepressionSchizophreniaNeurosesAlcohol dependenceIrish data550 - 7901301 - 22800-40110 - 1480No dataInternational data520 1000910 220010 3060 179020As we know, dementia occurs in approximately 5 percent of those aged 65 years and over and 20percent of those over 80. Depression in the community-dwelling elderly is somewhere in the regionof 10-15 per cent, but when it comes those in institutional care, it can rise to as much as 40percent. There is a huge hidden morbidity of depression which is not often recognised.Conference Proceedings