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Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

2011, Number 4

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Rev Invest Clin 2011; 63 (4)

Neuropsychiatric symptoms in older adults with and without dementia in urban and rural regions. Results of the 10/66 Dementia Research Group in Mexico

Rodríguez-Agudelo Y, Solís-Vivanco R, Acosta-Castillo I, García-Ramírez N, Rojas-de-la-Torre G, Sosa AL

Language: Spanish
References: 49
Page: 382-390
PDF size: 75.28 Kb.


ABSTRACT

Objective. To describe, in a Mexican sample of urban and rural residents older than 65 years, with and without dementia, the frequency and severity of neuropsychiatric symptoms. Material and methods. This work is part of the multi-center, epidemiological study carried out by the 10/66 Dementia Research Group, with 1,003 subjects from an urban region and 1,000 subjects from a rural region. Neuropsychiatric symptoms were assessed with the abbreviated version of the Neuropsychiatric Inventory (NPI-Q). Results. Eighty six and eighty five dementia cases were found in the urban and rural regions, respectively. Subjects with dementia were more frequently widows, older and less educated, and the ones from the rural region had fewer neuropsychiatric symptoms, compared to the urban region. In both regions all symptoms were more severe in subjects with dementia. A high frequency of affective symptoms (depression and apathy specially) was observed, and irritability and anxiety in second term. The caregiver stress levels were associated with the frequency and severity of symptoms. Conclusions. This is the first study reporting neuropsychiatric symptoms associated with dementia identified by means of culturally validated and population based diagnostic criteria, in Mexican residents of urban and rural settings.


REFERENCES

  1. ONU. World population ageing 1950-2050. Nueva York: ONU; 2002.

  2. Bédard M, Molloy D, Pedlar D, Lever J, Stones M. Associations between dysfunctional behaviors, gender, and burden in spousal caregivers of cognitively impaired older adults. Int Psychogeriat 1997; 9: 277-90.

  3. Ferri C, Prince M, Brayne C, Brodarty H, Fratiglioni L, Ganguli M, et al. Global prevalence of dementia: a Delphi consensus study. Lancet 2005; 366: 2112-7.

  4. Prince M, Ferri C, Acosta D, Albanese E, Arizaga R, Dewey M, et al. The protocols for the 10/66 dementia research group population-based research programme. BMC Public Health 2007; 7: 165.

  5. Cummings J, Miller B, Hill M, Neshkes R. Neuropsychiatric aspects of multiinfarct dementia and dementia of the Alzheimer type. Arch Neurol 1987; 44: 389-93.

  6. Finkel S, Costa e Silva J, Cohen G, Miller S, Sartorius M. Behavioral and psychological signs and symptoms of dementia: a consensus statement on current knowledge and implications for research and treatment. Int Psychogeriatr 1996; 8: 497-500.

  7. APA. Practice guideline for the treatment of patients with Alzheimer’s disease and other dementias of late life. Am J Psychiatry 1997; 154(Suppl.): S1-S39.

  8. Mega M, Cummings J, Fiorello T, Gornbein J. The spectrum of behavioral changes in Alzheimer’s disease. Neurol 1996; 46(1): 130-5.

  9. Alarcón-Velandia R. Alteraciones psiquiátricas en la demencia. En: Arango-Lasprilla J, Fernández-Guinea S, Ardila A (eds.). Las demencias. Aspectos clínicos, neuropsicológicos y tratamiento. México: Manual Moderno; 2003.

  10. Grossberg G. Clinical implications of new dementia research. En: 152 APA Annual Meeting. Washington, DC, 1999.

  11. Saz P, López-Antón R, Dewey M, Ventura T, Martín A, Marcos G, et al. Prevalence and implications of psychopathological non-cognitive symptoms in dementia. Act Psychiatr Scand 2009; 119: 107-16.

  12. Lyketsos C, Steinberg M, Tschanz J, Norton M, Steffens D, Breitner J. Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging. Am J Psychiatry 2000; 157: 708-14.

  13. Caputo M, Monastero R, Mariani E, Santucci A, Mangialasche F, Camarda R, et al. Neuropsychiatric symptoms in 921 elderly subjects with dementia: a comparison between vascular and neurodegenerative types. Act Psychiatr Scand 2008; 117: 455-64.

  14. Artaso-Irigoyen B, Goñi-Sarries A, Gómez-Martínez A. Deterioro funcional del paciente con demencia: influencia del grado de deterioro cognitivo, la comorbilidad física y las alteraciones neuropsiquiátricas. Rev Esp Geriatr Gerontol 2002; 37: 210-5.

  15. Cummings J, McPherson S. Neuropsychiatric assessment of Alzheimer’s disease and related dementias. Aging 2001; 13: 240-6.

  16. González-Salvador T, Lyketsos C, Baker A, Hovanec L, Roques C, Brandt J, et al. Quality of life of patients with dementia in long-term care. Int J Geriatr Psychiatry 2000; 15: 181-9.

  17. Cummings J, Cole G. Alzheimer disease. JAMA 2002; 287(18): 2335-8.

  18. Stern Y, Tang M, Albert M, Brandt J, Jacobs D, Bell K, et al. Predicting time to nursing home care and death in individuals with Alzheimer disease. JAMA 1997; 277: 806-12.

  19. Prince M, Acosta D, Chiu H, Scazufca M, Varghese M, 10/66 DRG. Dementia diagnosis in developing countries: a crosscultural validation study. Lancet 2003; 361: 909-17.

  20. Verheij R. Explaining urban-rural variations in health: A review of interactions between individual and environment. Soc Sci Med 1996; 42(6): 923-35.

  21. Philo C, Parr H, Burns N. Rural madness: a geographical reading and critique of the rural mental health literature. J Rural Stud 2003; 19: 259-81.

  22. Blackstock K, Innes A, Cox S, Smith A, Mason A. Living with dementia in rural and remote Scotland: Diverse experiences of people with dementia and their carers. J Rural Stud 2006; 22: 161-76.

  23. ADI. 2009; Available from: http://www.alz.co.uk/1066

  24. Llibre-Rodríguez J, Ferri C, Acosta D, Guerra M, Huang Y, Jacob K, et al. Prevalence of dementia in Latin America, India, and China: a population-based cross-sectional survey. Lancet 2008; 372: 464-74.

  25. Cummings J, Mega M, Gray K, Rosenberg-Thompson S, Carusi D, Gornbein J. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurol 1994; 44: 2308-14.

  26. Kaufer D, Cummings J, Ketchel P, Smith V, MacMillan A, Shelley T, et al. Validation of the NPI-Q, a brief clinical form of the Neuropsychiatric Inventory. J Neuropsychiatry Clin Neurosci 2000; 12(2): 233-9.

  27. Boada M, Cejudo J, Tárraga L, López O, Kaufer D. Neuropsychiatric Inventory Questionnaire (NPI-Q): validación española de una forma abreviada del Neuropsychiatric Inventory (NPI). Neurol 2002; 17(6): 317-23.

  28. Copeland J, Dewey M, Griffith-Jones H. A computerised psychiatric diagnostic system and case nomenclature for elderly subjects: GMS and AGECAT. Psychol Med 1986; 16: 89-99.

  29. Hall K, Hendrie H, Brittain H, Norton J. The development of a dementia screening interview in two distinct languages. Int J Methods Psychiatr Res 1993; 3: 1-28.

  30. Ganguli M, Chandra V, Gilby J, Ratcliff G, Sharma S, Pandav R, et al. Cognitive test performance in a community-based nondemented elderly sample in rural India: the Indo-US Cross National Dementia Epidemiology Study. Int J Psychogeriatr 1996; 8: 507-24.

  31. Mejía-Arango S, Miguel-Jaimes A, Villa A, Ruiz-Arregui L, Gutiérrez- Robledo L. Deterioro cognoscitivo y factores asociados en adultos mayores en México. Sal Pub Mex 2007; 49: S475-S481.

  32. Fabrigoule C, Letenneur L, Dartigues J, Zarrouk M, Commenges D, Barberger-Gateau P. Social and leisure activities and risk of dementia: A prospective longitudinal study. J Am Geriatr Soc 1995; 43: 485-90.

  33. Henderson A. Epidemiology of dementia disorders. Adv Neurol 1990; 51: 15-25.

  34. Arizaga R, Harris P, Allegri R. Epidemiología de las demencias. En; Arango-Lasprilla J, Fernández-Guinea S, Ardila A (eds.). Las demencias. Aspectos clínicos, neuropsicológicos y tratamiento. México: Manual Moderno; 2003.

  35. Mangone C. Enfermedad de Alzheimer. En: Micheli F, et al. (eds.). Tratado de neurología clínica. Argentina: Editorial Médica Panamericana; 2003.

  36. Katzman R. Education and the prevalence of dementia and Alzheimer’s disease. Neurology 1993; 43: 13-20.

  37. Fratiglioni L, Grunt M, Forsell Y, Viitanen M, Grafström M, Holmen K, et al. Prevalence of Alzheimer´s disease and other dementias in an elderly urban population: Relationship with age, sex and education. Neurology 1991; 41: 1886-92.

  38. Terry R, Masliah E, Salmon D, Butters N, De Teresa R, Hill R, et al. Physical basis of cognitive alterations in Alzheimer’s disease: synapse loss is the major correlate of cognitive impairment. Ann Neurol 1991; 30: 572-80.

  39. Andreasen N. The broken brain. Nueva York: Harper and Row; 1984.

  40. Okura T, Plassman B, Steffens D, Langa K. Prevalence of neuropsychiatric symptoms among older adults in the united states: The aging, demographics, and memory study. Alzheimer´s Dement 2009; 5(4): P374.

  41. Ferri C, Ames D, Prince M; 10/66 DRG. Behavioral and psychological symptoms of dementia in developing countries. Int Psychogeriatr 2004; 16(4): 441-59.

  42. Lyketsos C, Lopez O, Jones B, Fitzpatrick A, Breitner J, De- Kosky S. Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study. JAMA 2002; 288: 1475-83.

  43. Ikeda M, Fukuhara R, Shigenobu K, Hokoishi K, Maki N, Nebu A, et al. Dementia associated mental and behavioural disturbances in elderly people in the community: findings from the first Nakayama study. J Neurol Neurosurg Psychiat 2004; 75: 146-8.

  44. Geda Y, Roberts R, Knopman D, Petersen R, Christianson T, Pankratz V, et al. Prevalence of neuropsychiatric symptoms in mild cognitive impairment and normal cognitive aging: population based-study. Arch Gen Psychiatry 2008; 65(10): 1193-8.

  45. Amer-Ferrer G, De la Peña A, García-Soriano M, García-Martín A. Componentes principales del Inventario Neuropsiquiátrico en la enfermedad de Alzheimer. Definición de síndromes de conducta. Neurología 2005; 20(1): 9-16.

  46. Arango-Lasprilla J, Fernández-Guinea S. La enfermedad de Alzheimer. En: Arango-Lasprilla J, Fernández-Guinea S, Ardila A (eds.). Las demencias. Aspectos clínicos, neuropsicológicos y tratamiento. México: Manual Moderno; 2003.

  47. Arango-Lasprilla J, Fernández-Guinea S, Ardila A. Las demencias. Aspectos clínicos, neuropsicológicos y tratamiento. México: Manual Moderno; 2003.

  48. Pollero A, Gimenez M, Allegri R, Taragano F. Neuropsychiatric symptoms in patients with Alzheimer disease. Vertex 2004; 15(55): 5-9.

  49. Cummings J. Mild cognitive impairment and neuropsychiatric symptoms. En: Actualización en enfermedades neurodegenerativas: Demencias y enfermedades extrapiramidales. Unidad de Neurología de la Clínica Las Condes. Santiago, Chile; 2005.




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