DSM-III criteria and the clinical diagnosis of dementia: A nursing home study

Examinations were given to 64 elderly nursing home patients who met DSM III criteria for dementia to determine if a specific diagnosis for their dementing disorder could be established through clinical evaluation. Pre-established diagnostic criteria were followed in diagnosing the cause of a patient's dementia. The diagnostic criteria for primary degenerative dementia, multi-infarct dementia, or alcoholic dementia were the same as those in the DSM-III. All but four of the patients evaluated could be given a specific, criteria based diagnosis for the cause of their dementia. The two most common diag-noses were primary degenerative dementia (56%) and multi-infarct dementia (27%). Existing chart diagnoses for these 64 patients did not appear to be adequate as 39 % had only a nonspecific diagnosis such as "organic brain syndrome, " 30 % had no diagnosis of any kind related to an organic mental disorder, and 8 % had an inaccurate arteriosclerotic cerebro-vascular diagnosis. These results suggest that demented nursing home patients have discrete clinical syndromes which can be assigned a specific diagnosis and that the current clinical diagnosis of these disorders can be greatly improved. Key Words: Dementia, DSM HI, Nursing home D EMENTIA is a major neuropsychiatricsyndrome of later life, significantly dis-abling at least 5 % of persons over age 6