Aminoff Suffering Syndrome (ASS) a New Pathological Entity in End-Stage Dementia
Aminoff B. Z., MD, PhD
Geriatric division, Sheba Medical Center, Tel-Hashomer, 52621; Human Suffering and Satisfaction Research Center, Israel, El-Ad; E-mail: bechorz@yahoo.com
Health sciences/geriatric medicine
Introduction: There is insufficient clinical evidence for suffering in dying dementia patients and key criterions of irreversible medical condition, which may lead to inappropriate evaluation and insufficient palliative treatment.
Purpose of study is to evaluate the suffering syndrome of terminal dementia patients (MMSE=0/30, FIM=18/126) over time, from admission to a geriatric ward and on during six months follow up.
Methods and materials: A prospective study of consecutive end-stage dementia patients, admitted to a general geriatric department of a tertiary hospital. Patients were evaluated weekly by the scale (MSSE) which developed by us.
Results: Two hundreds patients have been studied. During six months follow up survived 88 (44%) and died 112 (56%) of end stage dementia (ESD) patients whom admitted to geriatric department. The MSSE scale score of six months survived ESD patients was low with MSSE=3.41±2.02 at day of admission and decreased during six months follow up to MSSE=2.77±1.90, P=0.003. In contrary, the MSSE scale score of died ESD patients was high with MSSE=4.97±2.46 at day of admission to geriatric department and increased until last day of life until MSSE=5.93±2.39, with significant difference P≤0.0001.
Conclusion: Our proposal Aminoff suffering syndrome in terminal dementia is the new pathological and geriatric symptomatology and entity which characterized by high MSSE scale score, irreversible and intractable aggravation of suffering and medical condition until death and less than six months survival. Aminoff suffering syndrome could be key criterion for enrolling ESD patients for palliative treatment. New alternative setting approaches as Relief of Suffering Units should be developed for end stage and dying dementia patients being in Aminoff suffering syndrome.