Prevalence of geriatric syndromes in patients with advanced dementia cared for by a Geriatric Home Care Unit

Abstract

Abstract

Geriatric syndromes are highly prevalent in older adults with advanced dementia, yet data in home-based geriatric care settings remain limited. We conducted a retrospective descriptive study including patients with advanced dementia (Global Deterioration Scale stages 6–7) attended by a specialized Home-Based Geriatric Care Unit between June and October 2021. Among 210 patients assessed, 48 (22.8%) had advanced dementia (mean age 90.8 years; 79.2% women). Severe or total dependence was present in 91.6%, all patients were frail (mean Clinical Frailty Scale 7.3), and the mean Charlson Comorbidity Index was 3.3. The most prevalent geriatric syndromes were urinary incontinence (100%), fecal incontinence (89.7%), sensory impairment (89.7%), insomnia (84.6%), caregiver burden (71.8%), dysphagia (69.2%), depressive syndrome (64.2%), pain (61.5%), and pressure ulcers (25.6%). Polypharmacy was frequent (mean 12.4 medications at admission), and 30-day mortality was 16.7%. These findings highlight the extreme clinical complexity of home-dwelling patients with advanced dementia and reinforce the importance of comprehensive geriatric assessment in this setting.

Keywords: Advanced dementia, geriatric syndromes, home-based care, frailty, comprehensive geriatric assessment