Comorbidity and clinical features in elderly patients with dementia: differences according to dementia severity.

OBJECTIVES: To evaluate comorbidity and clinical features in elderly patients with dementia to determine differences according to dementia severity. DESIGN: Observational study with medical record review. SETTING: Eight hospitals in the Barcelona area. PARTICIPANTS: 515 consecutive admissions aged > 64 years with dementia, 89.1% of whom lived in the community. MEASUREMENTS: We collected data on sociodemographic variables, type of dementia, Barthel Index (BI), Lawton and Brody Index (LI), Mini-Mental State Examination (MMSE), Charlson Index and the total number of drugs chronically prescribed. We stratified the population into two groups according to disease severity with the Global Deterioration Scale (GDS): mild-moderate (GDS 3-5) and severe (GDS 6-7). RESULTS: There were a total of 515 participants of which 364 females (70%) and 151 males with a mean age of 81 +/- 6 years old. The total number of chronic prescription drugs was 5.6 +/- 2.4. The mean Charlson Index score was 2 +/- 1.2. The 270 (52.5%) patients with a GDS score of 3-5 were compared with the 245 patients with a GDS score of 6-7. In the multivariate analysis, a GDS score of 6-7 was associated with poorer LI, BI, and MMSE scores and greater neuroleptic therapy. CONCLUSIONS: Important comorbidity conditions are common in elderly individuals with dementia. The patients with more severe dementia had poor functional status and higher frequency of neuroleptic use. Medical comorbidities should be taken into account in the management of patients with dementia.