As the American population continues to age, diagnosis of dementia will increase and the importance of cognitive screening will become increasingly important, suggest two studies in the May issue of the American Journal of Psychiatry.
A new study from John Hopkins University using data from the general hospital database on 21,251 patients aged 60 and older, found that patients with dementia had longer hospital stays, which translate into higher costs. The study found the mean length of stay was 10.4 days for patients with dementia and 6.5 days for those without dementia. The researchers suggest that early detection of dementia would expedite treatment and reduce costs. (1.)
Another study, from John Hopkins University, Utah State University, and Duke University found that dementia is often linked to other mental and behavioral disturbances. The investigators screened 5,092 community residents of Cache County, Utah for cognitive impairment. Screening results revealed that symptoms of other psychiatric illnesses were found in 61 percent of subjects with dementia. (2.)
"As our patients age, psychiatrists must increasingly inquire about another type of taboo: memory impairment," said Susan K. Schultz, M.D., University of Iowa Department of Psychiatry, in an accompanying Journal editorial. "The diagnosis of dementia is particularly difficult to talk about directly, perhaps because of its foreboding implicationsŠloss of autonomy, loss of dignity, and loss of the self."
Schultz also points out that while aging is the greatest risk factor for dementia, other contributing factors include head trauma, substance abuse, HIV or other central nervous system infections, vascular disease, chronic hypoxemia, hepatic and renal insufficiency, and other chronic illnesses.
1. ["Dementia in Elderly Persons in a General Hospital," by Constantine G. Lyketsos, M.D., et. al., p. 704] APAfastFAX#6931
2. ["Mental and Behavioral Disturbances in Dementia: Findings From the Cache Country Study on Memory in Aging," by Constantine G. Lyketsos, M.D., et. al., p. 708] APAfastFAX#6932
Editor's Note: May is Older Americans Month, sponsored by the Administration on Aging. For more information on Older Americans Month 2000, "The Future is Aging," contact 202-619-0724, or visit www.aoa.gov.
Also Note: For a free brochure from the APA's "Let's Talk Facts" series, contact 202-682-6000, or e-mail apa@psych.org and ask for "Mental Health of the Elderly," and "Alzheimer's Disease."
Also in the May issue of the American Journal of Psychiatry:
Alcoholism Risks Identified in Women, Teens
Three studies published in the May issue focus on the risks of alcohol in adolescents and women. Alcohol disorders among adolescents are serious, and by late adolescence approximately 10 percent of adolescents meet diagnostic criteria for an alcohol use disorder. A study of women showed that depression was a risk factor among those who were heavy drinkers.
In a study from the University of Pittsburgh, researchers found that brain structure may be altered in teen drinkers. Using magnetic resonance imaging to measure the hippocampal volumes, the finding suggests that during adolescence, the hippocampus‹the section of the brain important for long-term memory storage--may be particularly susceptible to the adverse effects of alcohol. (3.)
A study from the Centre for Addiction and Mental Health, London and Toronto reviewed data from a community sample of 5,856 lifetime drinkers and found that the earlier one begins drinking the more likely one is to develop alcohol disorders. Particularly, the first use of alcohol at ages 11-14 greatly increases the risk of alcohol disorders by as much as 15.9 percent. This study suggests that early intervention could avert problems in later life. (4.)
A study on women and alcohol from John Hopkins University found a connection between women experiencing depression and heavy alcohol consumption. Using a sample of 1,383 women at risk for heavy alcohol use, researchers found initial estimate of risk for heavy drinking in women with a history of depressive disorder was 2.60 times greater than the risk for women with no history of depressive disorders. The study suggests that depression must be considered in assessment, and that effective treatment of depression might reduce risk of later alcohol problems. (5.)
4. ["Hippocampal Volume in Adolescent-Onset Alcohol Use Disorders," by Michael D. De Bellis, M.D., et. al., p. 737] APAfastFAX#6933
5. ["Age at First Alcohol Use: A risk Factor for the Development of Alcohol Disorders," by David J. DeWit, et. al., p. 745] APAfastFAX#X6934
6. ["Prospective Study of Depression and the Risk of Heavy Alcohol Use in Women," by Anita R. Dixit and Rosa M. Crum, M.D., p. 751] APAfastFAX#6935
Editor's Note: For a free brochure from the APA's "Let's Talk Facts" series, contact 202-682-6000, or e-mail apa@apa.org and ask for "Substance Abuse and Addiction."
Copies of these articles are available in their entirety by calling APAfastFAX at 888-357-7924.
The American Psychiatric Association is a national medical specialty society, founded in 1844, whose nearly 40,000 physician members specialize in the diagnosis, treatment and prevention of mental illnesses and substance use disorders.
Journal
American Journal of Psychiatry