Severity of Dementia and Institutionalization in the Elderly: Prevalence Data from an Urban Area in Sweden

Abstract

This study investigated the severity of dementia in relation to disease type and sociodemographic variables. The dementia cases were detected with a two-phase study design in a population aged over 74 years in Stockholm. The prevalence of questionable, mild, moderate, and severe dementia was 1.0, 3.1, 5.5, and 2.3 per 100, respectively. Women aged over 84 had the highest prevalence of severe dementia. More severe cases and a higher institutionalization rate were present for vascular dementia than for Alzheimer''s disease. Fifty-five percent of the demented subjects but only 3% of the nondemented were institutionalized. The institutionalized demented subjects were affected mostly by moderate-severe dementia (88.6%), while the noninstitutionalized were affected more often by a questionable-mild form (68.3%).

Dementia in Subjects Aged 75 Years or Over within the PAQUID Cohort: Prevalence and Burden by Severity

“…Our results confirmed the main contribution of dementia in institutionalization [1,8,40] . The very high burden of dementia within these institutions, previously reported between 66 and 73% [1,8] , has been estimated at 72% of institutionalized residents suffering from dementia in our study.…”

“…The great majority of these cases were women. Even if severity of dementia cases is often evaluated [32] , few data have been published on the prevalence of dementia according to the severity of the disease [8][9][10][11] . However, as pointed out by Hy and Keller [11] , differences between studies in reported prevalence of dementia are lowered when including severity in the case definition.…”

“…In addition, the consequences of dementia, in terms of disability and institutionalization, depend on the severity of the disease [7] , and it is surprising that only very few studies have given estimations of the prevalence of dementia by severity of cognitive disorders [8][9][10][11] . It is however a crucial question in the assessment of needs in terms of social and health care services for patients.…”

Recruitment Procedures and Their Impact on the Prevalence of Dementia

“…The requirement to include institutionalized persons in representative community samples has been subject to debate. Based on a metaanalysis covering prevalence studies from 1945 to 1985, Jorm et al [18] found no effect Corso et al [21] [22] Oslo/Norway (urban) 3.8 (13/334) -Fratiglioni et al [23] Stockholm/Schweden (urban) 7.8 (141/1,810) + Pi et al [24] Catalunya/Spain (semi-rural) 5.9 (26/440) + D'Alessandro et al [20] Sicily/Italy (rural) 10.6 (39/365) + + Included, -= not included. 1 Rate was derived by the author based on data given in the original paper; numbers in parentheses indicate the actual numerator and denominator figures.…”

Epidemiology of Post-Stroke Dementia

“…The prospect of an increased burden on society in terms of health care has led to increased scientific interest in the different aspects of dementia in the last decades. Dementia appears to be more severe in patients with a presumed vascular cause [3,4]. Since vascular factors provide the best opportunities for prevention and intervention strategies, efforts have been made to distinguish a subgroup of patients with vascular dementia.…”