Current prevalence of dementia, depression and behavioural problems in the older adult care home sector: the South East London Care Home Survey.
BACKGROUND
a large and increasing number of older people in the UK are living in care homes. Dementia is a frequent reason underlying admission and determining care needs, but prevalence data are becoming increasingly outdated and reliant on brief screening instruments.


OBJECTIVE
to describe the prevalence and severity of dementia, depression, behavioural problems and relevant medication use in a representative sample of residential and nursing care home residents.


DESIGN/SETTING
a survey conducted in 15 randomly selected South East London care homes. Consensus clinical dementia diagnoses were made from multi-source information, and the Clinical Dementia Rating (CDR) Scale applied. Depression was ascertained using the Cornell Depression in Dementia Scale and psychological/behavioural problems using the Neuropsychiatric Inventory (NPI).


PARTICIPANTS
three hundred and one residents with a mean (SD) age of 83.5 (9.8) and 65.8% female were included.


RESULTS
dementia (CDR 1-3) prevalence was 75.1% overall, 55.8% in residential homes, 91.0% in residential elderly mentally infirm care and 77.0% in nursing homes. Depression prevalences were 26.5, 22.0 and 29.6%, respectively, and mean (95% CI) NPI severity scores 3.99 (3.47-4.50), 6.34 (5.29-7.39) and 6.10 (5.50-6.70) with 87.3% of the sample exhibiting at least one NPI symptom. Antidepressants were prescribed in 25.6, 25.0 and 41.3%, respectively, and antipsychotics in 7.0, 34.1 and 19.1%.


CONCLUSION
dementia is substantially more common in care homes than recorded diagnoses would suggest, but studies using brief screening instruments may overestimate prevalence. High prevalences of depressive and/or behavioural symptoms and psychotropic use suggest significant unmet need.
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D000368:Aged D000369:Aged, 80 and over D014150:Antipsychotic Agents D003625:Data Collection D003704:Dementia D003863:Depression D005260:Female D006707:Homes for the Aged D006801:Humans D007361:Intelligence Tests D008131:London D008297:Male D001523:Mental Disorders D009735:Nursing Homes D015995:Prevalence D012112:Residential Facilities D012720:Severity of Illness Index D011795:Surveys and Questionnaires
older people residential homes nursing homes mental health residential EMI