Abstract
Dementia and mild cognitive impairment (MCI) are an increasingly prevalent clinical entity in our field, showing an increasing incidence with age.ObjectiveThe purpose of this study was to identify the main types of dementia and MCI treated in a memory disorders unit in Costa Rica.MethodsA consecutive and standardized register of patients diagnosed with dementia and MCI at the memory disorders unit of the National Geriatrics and Gerontology Hospital (NGGH) was analyzed.ResultsDementia was diagnosed in 63.5% of the 3572 cases, whereas 10.6% met criteria for MCI. The most frequent type of dementia was Alzheimer's disease (47.1%), followed by vascular pathology (28.9%), mixed forms (17.2%) and other types (6.8%). In MCI, 69.5% were of amnestic multiple domain type and 14.3% were non-amnestic multiple domain, while 41.3% were of vascular and 35.8% of neurodegenerative etiology. Mean age was 79.6±6.7 years and 64.7% were women in dementia cases whereas mean age was 76.4±6.9 years and 62.1% were women in MCI. Mean years of schooling was 4.95±4.09 years and 6.87±4.71, while mean time between onset of symptoms and clinical diagnosis was 3.2±2.6 years and 2.67±2.69 years, in dementia and MCI, respectively.ConclusionThe determination of the main types of dementia and MCI in Costa Rica and their main features has allowed the registration of comprehensive, hitherto unavailable information that will be useful for the management and strategic planning of public health care.
Highlights
Alzheimer’s disease (AD) and other dementias in developed countries have become one of the leading causes of death, with very high direct and indirect care costs
The National Geriatrics and Gerontology Hospital (NGGH) in San Jose, Costa Rica, is the only Memory Clinic in the country dedicated to the evaluation, diagnosis and treatment of memory disorders, mild cognitive impairment (MCI) and dementia, operating under international protocols since February 2007
All patients were analyzed according to the same process of standardized assessment by evaluators from the Memory Clinic, which included: medical history and complete physical examination, application of the Mini-Mental State Examination (MMSE) test,[5] the Clock Drawing Test when applicable, using the Cacho et al scoring method,[6] the Clinical Dementia Scale (Clinical Dementia Rating - CDR),[7] the Barthel Rating Scale for activities of daily living,[8] the Lawton rating scale for instrumental activities of daily living,[8] the Yesavage Geriatric Depression Scale (GDS), 15-point version,[9] the Cummings Neuropsychiatric Inventory (NPI)[10] and the Reisberg Global Deterioration Scale (Global Deterioration Scale -GDS).[11]
Summary
Alzheimer’s disease (AD) and other dementias in developed countries have become one of the leading causes of death, with very high direct and indirect care costs. Number of such cases around the world is set to reach 115.4 million.[1] In developing countries, the incidence of dementia is believed to be increasing, with Latin America estimated to lead in case growth by 2050. In most Latin-American countries, patients with dementia receive medical attention in private clinics or otherwise are offered partial subsidies.[2] Even though a significant growth in people with dementia in this region of the American continent is expected, there is no data available for all countries in the region, including Central America.[3] In the case of MCI, there is less data still. The National Geriatrics and Gerontology Hospital (NGGH) in San Jose, Costa Rica, is the only Memory Clinic in the country dedicated to the evaluation, diagnosis and treatment of memory disorders, MCI and dementia, operating under international protocols since February 2007
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