Cognitive and clinical psychiatric profile of elderly served in a specialized ambulatory

Keywords: dementia, depression, aged, mental status and dementia tests

Abstract

Aims: to describe the cognitive and psychiatric clinical profile of older adults from primary care who are seen at a specialized outpatient clinic of a university hospital.
Methods: this was a cross-sectional, descriptive and analytical study, prospectively collected from a sample of the elderly population (60 years or older) enrolled in the Family Health Strategy of the city of Porto Alegre and treated at a specialized outpatient clinic of a university hospital during the study period. July 2015 to July 2016. The variables analyzed were sociodemographic (gender, age, education), clinical (psychiatric diagnosis) and cognitive assessment (Addenbrooke Cognitive Examination - revised version, ACE-R). The research protocol was approved by the Research Ethics Committees and all participants signed the Informed Consent Form.
Results: 256 individuals with a mean age of 70.8 ± 7.1 years were evaluated, mostly women (77.7%) and with 4 to 7 years of study (32.2%). Of these 54.3% had some cognitive impairment and 43.4% were classified as having dementia through the ACE-R assessment.
Conclusions: the cognitive and clinical psychiatric profile of the study participants showed that in the normal group, the elderly were younger and more educated and in the dementia group the individuals were older, less educated and diagnosed with depression.

Downloads

Download data is not yet available.

Author Biographies

Bruno Lodi, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS

Especialista em Psiquiatria pela Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), em Porto Alegre, RS, Brasil

Paula Engroff, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS

Doutora em Gerontologia Biomédica pela Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), em Porto Alegre, RS, Brasil.

Francisco Pascoal Júnior, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS

Doutor em Gerontologia Biomédica pela Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), em Porto Alegre, RS, Brasil.

Guilherme Marcos Nogueira, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS

Mestre em Gerontologia Biomédica pela Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), em Porto Alegre, RS, Brasil.

Vanessa Sgnaolin, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS

Doutora em Gerontologia Biomédica pela Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) em Porto Alegre, RS, Brasil.

Alfredo Cataldo Neto, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS

Doutor em Medicina e Ciências da Saúde pela Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), em Porto Alegre, RS, Brasil; professor da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), em Porto Alegre, RS, Brasil.

References

Instituto Brasileiro de Geografia e Estatística. Projeção da população do Brasil e das Unidades da Federação. Brasília: Instituto Brasileiro de Geografia e Estatística; 2019. [Capturado 2019 Abr 21]. Disponível em: https://www.ibge.gov.br/apps/populacao/projecao/.

World Health Organization. Global action plan on the public health response to dementia 2017–2025. Geneva: World Health Organization; 2017. [capturado 2019 Out 10]. Disponível em: https://apps.who.int/iris/bitstream/handle/10665/259615/9789241513487-eng.pdf;jsessionid=6ED79C2EEE9FEF970C6F92127E94541B?sequence=1.

World Health Organization. Dementia. Geneva: World Health Organization; 2019 [capturado 2019 Out 10]. Disponível em: https://www.who.int/en/news-room/fact-sheets/detail/dementia?.

Prince M, Bryce R, Albanese E, Wimo A, Ribeiro W, Ferri CP. The global prevalence of dementia: a systematic review and metaanalysis. Alzheimers Dement. 2013;9(1):63-75. https://doi.org/10.1016/j.jalz.2012.11.007.

Chaves ML, Camozzato AL, Godinho C, Piazenski I, Kaye J. Incidence of Mild Cognitive Impairment and Alzheimer Disease in Southern Brazil J Geriatr Psychiatry Neurol. 2009;22(3):181-7. https://doi.org/10.1177/0891988709332942.

Nitrini R, Caramelli P, Herrera E, Bahia VS, Caixeta LF, Radanovic M, Anghinah R, Charchat-Fichman H, Porto CS, Carthery MT, Hartmann AP, Huang N, Smid J, Lima EP, Takada LT, Takahashi DY. Incidence of Dementia in a Community-Dwelling Brazilian Population. Alzheimer Dis Assoc Disord. 2004;18(4):241-6.

Andreasen P, Lönnroos E, von Euler-Chelpin MC. Prevalence of depression among older adults with dementia living in low- and middle-income countries: a cross-sectional study. Eur J Public Health. 2014;24(1):40-4. https://doi.org/10.1093/eurpub/ckt014.

Silva, AR, Sgnaolin, V, Nogueira, EL, Loureiro F, Engroff P, Gomes I. Non-communicable chronic diseases and sociodemographic associated with symptoms of depression in elderly. J Bras Psiquiatria. 2017;66(1):45-51. https://doi.org/10.1590/0047-2085000000149.

César KG, Yassuda MS, Porto FHG, Brucki SMD, Nitrini R. Addenbrooke’s cognitive examination-revised: normative and accuracy data for seniors with heterogeneous educational level in Brazil. Int Psychogeriatr. 2017;29(8):1345-53. https://doi.org/10.1017/S1041610217000734.

Brasil. Conselho Nacional de Saúde. Resolução nº 466 de 12 de dezembro de 2012. [capturado 2019 Out 24]. Disponível em: http://bvsms.saude.gov.br/bvs/saudelegis/cns/2013/res0466_12_12_2012.html.

Bowen CE, Kessler EM, Segler J. Dementia worry in middle-aged and older adults in Germany: sociodemographic, health-related and psychological correlates. Eur J Ageing. 2018 Feb;28;16(1):39-52. https://doi.org/10.1007/s10433-018-0462-7.

Bottino CM, Azevedo D Jr, Tatsch M, Hototian SR, Moscoso MA, Folquitto J, et al. Estimate of dementia prevalence in a community sample from São Paulo, Brazil. Dement Geriatr Cogn Disord. 2008;26(4):291-9. https://doi.org/10.1159/000161053.

Perera G, Pedersen L, Ansel D, Alexander M, Arrighi HM, Avillach P, Foskett N, Gini R, Gordon MF, Gungabissoon U, Mayer MA, Novak G, Rijnbeek P, Trifirò G, van der Lei J, Visser PJ, Stewart R. Dementia prevalence and incidence in a federation of European Electronic Health Record databases: The European Medical Informatics Framework resource. Alzheimers Dement. 2018 Feb;14(2):130-9. https://doi.org/10.1016/j.jalz.2017.06.2270.

Souza RKM, Barboza AF, Gasperin G, Garcia HDBP, Barcellos PM, Nisihara R. Prevalência de Demência em pacientes atendidos em um hospital privado no sul do Brasil. Einstein (São Paulo). 2020;18:1-7

de Miranda LFJR, Matoso RO, Rodrigues MV, de Lima TOL, Nascimento AF, Carvalho FC, Moreira DRM, Fernandes JC, de Paula JJ, Magno LAV, Caramelli P, de Moraes EN. Factors influencing possible delay in the diagnosis of Alzheimer’s disease Findings from a tertiary Public University Hospital. Dement Neuropsychol. 2011;5(4):328-331.

https://doi.org/10.1590/S1980-57642011DN05040011.

Bottino CM, Azevedo D Jr, Tatsch M, Hototian SR, Moscoso MA, Folquitto J, et al. Estimate of dementia prevalence in a community sample from São Paulo, Brazil. Dement Geriatr Cogn Disord. 2008;26(4):291-9. https://doi.org/10.1159/000161053.

Correa Ribeiro PC, de Souza Lopes C, Lourenço RA. Prevalence of dementia in elderly clients of a private health care plan: a study of the FIBRA-RJ, Brazil. Dement Geriatr Cogn Disord. 2013;35(1-2):77-86. https://doi.org/10.1159/000345984.

Darwish H, Farran N, Assaad S, Chaaya M. Cognitive Reserve Factors in a Developing Country: Education and Occupational Attainment Lower the Risk of Dementia in a Sample of Lebanese Older Adults Front. Front Aging Neurosci. 2018;10:277. https://doi.org/10.3389/fnagi.2018.00277.

Sobral M, Pestana MH, Paul C. The importance of quantification of cognitive reserve. Rev port enferm saúde mental. 2014;12:51-8.

Farina M, Paloski LH, Oliveira CR, Argimon IIL, Irigaray TQ. Cognitive Reserve in Elderly and Its Connection with Cognitive Performance: A Systematic Review. Ageing Int. 2018;43(4):496–507. https://doi.org/10.1007/s12126-017-9295-5.

Singh-Manoux A, Dugravot A, Fournier A, Abell J, Ebmeier K, Kivimäki M, Sabia S. Trajectories of Depressive Symptoms Before Diagnosis of Dementia: A 28-Year Follow-up Study. JAMA Psychiatry. 2017 Jul 1;74(7):712-718. https://doi.org/10.1001/jamapsychiatry.2017.0660.

Alexopoulos GS, Meyers BS, Young RC, Mattis S, Kakuma T. The course of geriatric depression with “reversible dementia”: a controlled study. Am J Psychiatry. 1993;150(11):1693-9. https://doi.org/10.1176/ajp.150.11.1693.

Enache D, Winblad B, Aarsland D. Depression in dementia: epidemiology, mechanisms, and treatment. Curr Opin Psychiatry 2011;24:461-72. https://doi.org/10.1097/YCO.0b013e32834bb9d4.

Reijnders JS, Ehrt U, Weber WE, Aarsland D, Leentjens AF. A systematic review of prevalence studies of depression in Parkinson’s disease. Mov Disord. 2008;23:183-9. https://doi.org/10.1002/mds.21803.

Beckert M, Loureiro F, Menta C, Mello EF, Nogueira EL, von Gunten A, Gomes I. Performance of low-educated elders with depression on Addenbrooke’s Cognitive Examination-Revised (ace-r) test. Dement Neuropsychol. 2016 Jan-Mar;10(1):19-25. https://doi.org/10.1590/s1980-57642016dn10100004.

Vismari L, Alves GJ, Palermo-Neto J. Depressão, antidepressivos e sistema imune: um novo olhar sobre um velho problema. Rev Psiquiatr Clín. 2008;35(5):196-204. https://doi.org/10.1590/S0101-60832008000500004.

American Psychiatry Association. Diagnostic and Statistical Manual of Mental disorders - DSM-5. 5th.ed. Washington: American Psychiatric Association; 2013. https://doi.org/10.1176/appi.books.9780890425596.

Rock P, Roiser J, Riedel W, Blackwell A. Cognitive impairment in depression: A systematic review and meta-analysis. Psychol Med. 2014;44(10):2029-40. https://doi.org/10.1017/S0033291713002535.

Published
2020-08-31
How to Cite
Lodi, B., Engroff, P., Pascoal Júnior, F., Nogueira, G. M., Sgnaolin, V., & Cataldo Neto, A. (2020). Cognitive and clinical psychiatric profile of elderly served in a specialized ambulatory. PAJAR - Pan American Journal of Aging Research, 8(1), e36639. https://doi.org/10.15448/2357-9641.2020.1.36639
Section
Original Article