Authors (including presenting author) :
Wong MMC (1), Pang PF(1)
Affiliation :
(1) Department of Psychiatry, UCH
Introduction :
There are concerns about adequacy of care for people with severe mental illnesses (SMI) who have grown old. About 60% of the patients studied were found to have clinically relevant cognitive impairment. It is worthwhile to find out more about need of these “graduate” patients especially in cognitive functioning. The Dementia Community Support Scheme (DCSS) is a pilot program that aims to develop clinical expertise, as well as to provide training to patients with mild to moderate grade dementia at District Elderly Community Center (DECC). The program would be extended to all DECCs in Hong Kong in 2019. These aging SMI sufferers could be potential beneficiaries of the DCSS if their cognitive impairment could be detected promptly.
Objectives :
We have conducted a pilot study to assess the cognitive functioning of elderlies with different SMI who were followed up by the adult psychiatric specialist outpatient department (SOPD) of the Department of Psychiatry of the United Christian Hospital. We assessed the cognitive functioning of elderlies with different SMIs who were followed up by the adult psychiatric clinic and we would like to identify suitable patients for DCSS.
Methodology :
Thirty consecutive patients were selected from three age groups (65-70, 71-75 and 76 or above). Nurses of the psychiatric SOPD would help to perform global deterioration scale (GDS) which provides an overview of the stages of cognitive symptoms of these patients before they see their doctors. The scores would be made known to the case doctor during follow up. Suitable patients (mild to moderate dementia) would be referred by the case doctor to the DCSS.
Result & Outcome :
For the 65-70 group, only two (6.7%) patients had GDS rating higher than 3. For the 71-75 group, five (16.7%) patients were found to have GDS rating higher than 3. Four (80%) of them had reported to have symptoms of cognitive decline but no cognitive assessment was done. For the 76 or above group, only one patient reported symptoms of cognitive decline before. Seven (23.3%) patients had GDS rating higher than 3, three of them were in grade 4, one in grade 5, two in grade 6 and one in grade 7.
Only a small number of patients had symptoms of cognitive decline being documented in the case notes even though their GDS rating later found that they were at least mild to moderately demented. Regarding referral to DCSS, it was likely to be most fruitful if recruitment could be targeted at the 71-75 age group. More of them were in mild dementia comparing to the youngest group. Patients in the 76 or above age group might already have moderate to severe dementia and their activities of daily living had become dependent.
Co-location with:
