As you make your bed, so one thinks

may be inclined regard to dementia be

Scientists at the University of Leipzig and the University of Würzburg made recently an exciting, strange new discovery: The more skewed to a patient lies in his bed, the more difficult might be the degree of cognitive impairment. If an inclined position in the patient is detected, dementia or a preliminary stage of dementia may be present; The reports are published in the "British Medical Journal."

The special thing about this discovery is that the attending physician prior to the use of specific test procedures already from the mere observation of spontaneous behavior of a patient receives an indication that the cognitive performance of patients may be affected. So new diagnostic considerations targeted and treatment options can be initiated sooner. The study was published recently in the prestigious scientific journal "British Medical Journal" ( "Lying obliquely - a clinical sign of cognitive impairment: cross sectional observational study," BMJ.2009, Dec 16; 339: b5273).

Spatial disorientation

Prof. Dr. med. Joseph Claßen, Director of the Clinic and Polyclinic for Neurology, and his team attribute the inclination to a spatial disorientation that makes it impossible for those affected to position themselves in a delimited space. For the survey, the neurology patients were asked to lie down in their bed from sitting. The patient's position was then recorded with an overhead camera. Patients who were unable to move adequately because of other disorders were not included in the study. In order to determine the degree of the cognitive disorder, the specialists carried out three established neuropsychological test procedures with the patients, the mini mental screening test, DemTect test and clock mark test. The result was clear for all test procedures: the degree of the inclination and the severity of the impairment were closely related.

The more crooked someone lies down, the more their cognitive performance is impaired. The ability to position one's own body in an external given framework is apparently restricted even in the preliminary stages of dementia. All neurologists were shown pictures of a person lying at different angles in order to determine which position was perceived as "oblique".

A deviation of 7 ° and more from the longitudinal axis of the bed was recognized by 90% of all participating neurologists as clearly crooked with the naked eye. Neurologists or other doctors do not have to measure the angle, but can rely on their own assessment. If the attending physicians notice that a patient is tilted, they should keep in mind that there is a high probability that the patient is cognitively impaired.

Clinical signs

"In the early stages, cognitive disorders are usually not detectable without extensive testing. An inclined position is an indication for the attending physician, because healthy adults spontaneously go straight to bed. The doctor can now direct his attention to a possible cognitive impairment earlier carry out further examinations in a more targeted manner. We hope that this will facilitate the early detection of dementia, "explains Claßen, a specialist in movement disorders and strokes. The study shows that what doctors recognize as clearly crooked in a normal round is highly likely to be associated with cognitive impairment. Other established clinical signs, such as a searching reflex when stroking a patient's cheek or a pronounced grasping reflex when shaking hands, can only be inferred if dementia is already advanced. With the crooked positioning in bed, a new simple clinical sign was discovered that could reveal a cognitive disorder earlier and provide insight into the development of dementia.

Source: Leibzig / Würzburg [University]