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Valoración funcional en la demencia grave
Institution:1. Servicio de Urgencias. Hospital Clínico San Carlos. Madrid. España;2. Servicio de Geriatría. Hospital Clínico San Carlos. Madrid. España;1. Unidad de Patología de la Memoria;2. Sección de Neurología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España; Universidad de Alcalá, Alcalá de Henares, Madrid, España;1. Departamento de Psicología Clínica y de la Salud, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, España;2. Departament de Benestar i Familia-SISPAP/Grup Mutuam, Residencia y Centro de Día Sant Cugat, Sant Cugat del Vallés, Barcelona, España;3. Asociación Multidisciplinar de Psicogeriatría y Demencias (AMPIDE), Sant Cugat del Vallés, Barcelona, España;4. Centro Sanitario Can Mora, Sant Cugat del Vallés, Barcelona, España;1. Servicio de Geriatría, Hospital Universitario de Getafe, Madrid, España;2. Servicio de Geriatría, Complejo Hospitalario Universitario de Albacete, Albacete, España;3. Servicio de Geriatría, Complejo Hospitalario de Navarra-A, Pamplona, España;4. Servicio de Geriatría, Hospital Monte Naranco Oviedo, Oviedo, España;5. Servicio de Geriatría, Hospital Universitario San Carlos, Madrid, España;6. Servicio de Urgencias, Hospital Universitario San CarlosMadrid, España;7. Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España;8. Servicio de Urgencias, Hospital Universitario San Carlos, Madrid, España;9. Servicio de Geriatría, Hospital General de Granollers, España;10. Servicio de Geriatría, Complexo Hospitalario Universitario Xeral Calde de Lugo, Lugo, España
Abstract:Severe dementia is currently one of the main causes of dependence and is defined as cognitive impairment that interferes with the performance of basic activities of daily living. However, in clinical practice severe dementia is difficult to define.Assessment of the ability to perform activities of daily living is a key factor in patients with severe dementia, since functional impairment is a defining feature. Assessment allows an accurate prognosis to be made and a care plan to be established, as well as the effectiveness of the intervention to be evaluated, when necessary.Functional assessment in dementia is complex, since functional status is the expression of multiple interactions, especially in geriatric patients. Functional status is measured by functional scales. In severe dementia, these scales must evaluate basic activities of daily living in the different types of dementia with high sensitivity to changes and strong discriminatory capacity. They should also be culturally adapted and validated in the community and institutional settings. Consensus should be established on the use of these instruments to allow them to be standardized and their results to be compared.
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