It is an unfortunate fact that people with dementia may be openly or implicitly excluded from some of the most important treatments in general hospital. Older studies have tended to show poor outcomes for people with dementia in general hospital. A recent carefully conducted prospective study examined the contribution of dementia to three key adverse outcomes among older hospital inpatients; length of stay, death and institutionalization. After controlling for medical co-morbidity, dementia was predictive only of institutionalization. This emphasizes the importance of focusing on co-morbidities in people with dementia. An influential study in this area was that of Huusku et al. A sample of 243 older Finnish people with hip fracture was randomized to receive either care as usual or an intensive geriatric rehabilitation programme as general hospital inpatients. A subgroup analysis showed that people with mild dementia had better outcomes when given active rehabilitation. This difference was far greater for those with moderate dementia. There was no overall difference in outcome for those people without dementia compared with people with dementia. A far higher proportion of those with dementia who had intensive rehabilitation were living independently at follow up. A meta-analysis of interventions to prevent falls among people with dementia and cognitive impairment showed that multifaceted interventions in general hospital settings could reduce falls and that degree of dementia had no effect on outcomes.
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http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=1094&pageNumber=5