Authors: M. Horáčková 1; T. Tošnerová 1; S. Vaňková 2; R. Šafářová 2; J. Herink 2; M. Berdych 2 Authors‘ workplace: Ústav etiky 3. LF UK, Praha, přednosta doc. MUDr. J. Šimek, CSc. 2I. interní klinika 3. LF UK, Praha, přednosta prof. MUDr. J. Horák, CSc. 1 Published in: Prakt. Lék. 2000; (1): 39-43 Category:
The dynamics of ageing of the Czech population are associated with medical, ethical andsocioeconomic problems. The multimorbidity of senior citizens represented by a complex oforganic diseases and psychopathological manifestations is a serious problem of nursing care inhomes as well as hospitals. The key to a solution can be early diagnosis of manifestations oforganic diseases and correct diagnostic classification of mental disorders in old age. An essentialstep is the correct approach to the differential diagnosis of psychopathological manifestationsin old age. The selection of screening tests for detection of the most frequent psychiatriccomorbidities - dementia and depression - is important. In the submitted paper the authorspresent information on the use of the Mini-Mental-State questionnaires according to Folesteinand the geriatric Depression Scale according to Yesavage standardized for the Czech population,in multimorbid senior subjects hospitalized at the medical clinic and the haemodialyzationcentre. The disentangling of problems associated with organic and mental diseases from ethical,social and economic problems calls for a multidisciplinary approach. The authors summarizethe outcomes of team work focused on the patient™s diagnosis and made a pilot study of theprevalence of dementia and depression in multimorbid senior subjects. The prevalence ofdepression is high in mutlimorbid old people: in hospitalized ones 31%, in dialyzed ones 40%.In both groups depressive women predominate. The prevalence of dementia in the populationof multimorbid hospitalized old people is 17%, in the dialyzed population 14%. 14% of thenon-dialyzed patients took regularly benzodiazepine hypnotics and 26% analgesics. 34% of thedialyzed senior patients took benzadiazepine hypnotics, another 17% alprazolam, 37% tookanalgesics regularly.
Key words: memory disorders - psychopathology - multimorbidity of senior subjects - differentialdiagnosis.
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