To evaluate the cognitive status in an elderly population including both community-dwellers and institutionalised subjects.

462 subjects (mean age 85.1±6.9 years, 53.2% females) living in the Faenza district (Ravenna, Northern Italy) were interviewed and clinically evaluated. The Cambridge Mental Disorders of the Elderly Examination (CAMDEX) was administered to all participants to collect socio-demographic and clinical information. The cognitive status was evaluated using the cognitive assessment included in the CAMDEX (CAMCOG) and the Mini-Mental State Examination (MMSE) (adjusted by sex and age). Cut-offs were as follow: CAMCOG scores < 80; MMSE scores < 24.

The CAMCOG identified 245 subjects (53.0%) as cognitively impaired; 132 persons (28.6%) had a MMSE score < 24 and were impaired in the activities of daily living. Prevalence of dementia (DSM-IV criteria) was 19.1% (N=88), including 11 cases of ‘questionable’ dementia. Demented subjects were more likely to be women (65.9%), were less educated (p< 0.05) and older than non-demented (p< 0.001). Demented subjects scored significantly lower than non-demented subjects in any cognitive domain at CAMCOG (p< 0.001).

Cognitive domains: mean score and standard deviation (p< 0.001).

Non-demented vs Demented

All subjects: 78.4(±15.9) vs 28.7(±21.7)

Males: 81.1(±13.0) vs 35.0(±19.9)

≤85: 83.3(±12.3) vs 38.0(±20.5)

>85: 75.7(±13.2) vs 34.0(±20.2)

Females all: 75.7(±18.0) vs 24.3(±21.9)

≤85: 82.5(±12.4) vs 58.5(±10.8)

>85: 67.0(±20.2) vs 18.4(±17.5)

Among demented subjects, only 4.5% were treated with acetylcholinesterase inhibitors (p=0.046); 10.2% used other anti-dementia medications (p=0.067).

Despite of the high prevalence of dementia, only few subjects affected by dementia were properly treated.