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#HRB30 Story

Shining a light on ‘hidden dementia’ in hospitals

19 December 2016

The HRB-funded Cork Dementia Study analysed patients aged over-70 in Cork hospitals and found that 25% of the patients had dementia, rising to 37% prevalence in smaller rural hospitals. Many patients had not been previously diagnosed. Staff felt underprepared to help such patients.

Around half of the people with dementia also had delirium, a short-term confusion that can happen with trauma or illness.

The Cork Dementia Study led on to a national audit of dementia among older patients in Irish hospitals, and has identified the need for more education and training among hospital staff and more effective diagnosis of people with dementia in the community before they reach hospital.

University College Cork, lead researcher Dr Suzanne Timmons

The problem

When older people come into hospital, they may have some trouble with ‘cognitive’ functions like memory and attention. This could be because they have mild or severe dementia (which might not be diagnosed) or a more short-term confusion called delirium, which can be caused by trauma or illness. Up until now we haven’t known the extent of the problem.

The project

Researchers at University College Cork gathered information about patients over age 70 who were admitted to six hospitals in Cork during a two-week period. Patients who took part in the study were assessed for dementia and delirium, and the researchers also asked hospital staff about their experiences of dealing with older patients who had cognitive issues.

The outcomes

The study showed that:

  • A quarter of patients aged over 70 who come in to hospital may have dementia (many undiagnosed) and/or delirium. 
  • Older patients with pneumonia are more likely to be among the group with dementia or delirium, and patients coming in for elective procedures are less likely to have dementia or delirium.
  • Hospital staff often feel underprepared or find it hard to cope when older patients are confused or distressed because of these cognitive issues.

The HRB study led on to the National Audit of Dementia (co-funded by Atlantic Philanthropies), which gathered information about patients and staff in 47 hospitals around Ireland and was included in the Irish National Dementia Strategy.

Dr Suzanne Timmons says: 'Getting the figures for dementia and delirium among older patients in hospitals in Cork has been a really important step, and it has fed into a louder national conversation about the need for more appropriate care for patients with dementia. The Cork Dementia Study has given us a glimpse of how big the problem is, and now we can set about changing practice to improve education and care for hospital patients with dementia in Ireland, such as ensuring patients are moved less, that their medication is appropriate and that staff engage with them in ways they are more likely to understand'.

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