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Dementia01:30

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Dementia is a collective term for cognitive disorders primarily affecting memory, thinking, and reasoning. It is not a specific disease but a syndrome, with Alzheimer's disease being the most common cause, accounting for approximately 60-80% of cases. Other types include vascular dementia, Lewy body dementia, and frontotemporal dementia. Dementia affects millions worldwide, particularly older adults, though it is not a normal part of aging.
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Decision Making01:20

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Prevalence and decision-making in advanced dementia.

A Castellano Candalija1, L Díez Porres1, H Notario Leo2

  • 1Hospital La Paz, Madrid, Spain.

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|November 13, 2025
PubMed
Summary

Advanced dementia (AD) patients admitted to internal medicine have a high prevalence and mortality. Therapeutic adequacy and care planning were found to be very scarce in this vulnerable population.

Keywords:
Advanced dementiaCare planningCognitive impairmentDemencia avanzadaDeterioro cognitivoPlanificación de cuidados

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Area of Science:

  • Gerontology
  • Internal Medicine
  • Neurodegenerative Diseases

Background:

  • Dementia represents a significant public health challenge due to its high prevalence and associated economic burden.
  • Advanced dementia (AD) patients frequently require hospitalization, particularly within internal medicine services.
  • Understanding the care provided to these patients is crucial for improving health outcomes.

Purpose of the Study:

  • To determine the prevalence of advanced dementia (AD) admissions in internal medicine.
  • To analyze the diagnostic and therapeutic interventions employed for these patients.
  • To assess the adequacy of care and family communication.

Main Methods:

  • A descriptive study utilizing retrospective analysis of medical records.
  • Inclusion criteria: patients with Global Deterioration Scale (GDS) 6-7 dementia admitted to Internal Medicine.
  • Data collection included a telephone interview with family members.

Main Results:

  • 11% of internal medicine admissions were patients with advanced dementia (AD).
  • Infections were the primary cause of admission (72%), with a 37% mortality rate.
  • Therapeutic interventions were extensive, but adequacy of care (34%) and palliative care involvement (13%) were low. Family awareness of complications was also limited (42%).

Conclusions:

  • Advanced dementia (AD) admissions are common, with a significant proportion originating from elderly care residences.
  • High mortality rates underscore the severity of illness in this population.
  • There is a critical need to improve therapeutic adequacy and advance care planning for hospitalized AD patients.