Abstract
Illiteracy is a risk factor for the occurrence of dementia and is associated with a lower cognitive reserve, but patients with a higher educational level tend to have a faster cognitive decline. One hundred and fort three patients with Alzheimer Disease an outpatient clinic of cognitive disorders in the northeastern region of Brazil were followed retrospectively. All patients were a follow-up at least 1 year. Patients who presented stability or increase in the MMSE score between the first and last visit were considered good responders. Student T test, Mann-Whitney test and Chi-square were used to compare good response and the group without good. A logistic regression analysis was performed to identify independent factors of good response. The mean age of onset of symptoms was 73.4(±7.2) years, with a predominance of females of 99 (69.2%). The illiteracy rate was 25.9% (37) and 63% (90) had less than 4 years of study. The mean initial MMSE was 15.3(±5.6) points. The mean follow-up of the patients was 29.96 (±16.2) months and the mean last MMSE was 12.79 (±6.5) points. During this follow-up period, 39 patients (27.3%) had a good response to treatment. There was no difference between good and no responders according to age and follow-up time, but there was a tendency to lower initial MMSE 14.4(±4.8) x 16.4(±5.8) (p = 0.07) and lower initial score in Pfeffer scale 16.5(±8.2) x 20, 68(±8) (p = 0.05). There was a higher frequency of dyslipidemia 62.16 x 36.14 (p = 0.01) and illiteracy 51.42% x 21.11 (p = 0.02) in good responders. The presence of neuropsychiatric symptoms in follow up was more frequent in non responders (69.9% x 50%) p = 0.046. In the logistic regression, only illiteracy (OR 5.23 CI 1.87–14.77) and dyslipidemia (OR 4.53 CI 1.75–11.73) had an association with good prognosis. Illiteracy and dyslipidemia were associated with good evolution in a group of patients with AD and low educational level.
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