Diego Sarasola | Universidad Nacional de La Plata (original) (raw)
Papers by Diego Sarasola
La Enfermedad de Alzheimer es la causa más frecuente de trastornos cognitivos y demencia en adult... more La Enfermedad de Alzheimer es la causa más frecuente de trastornos cognitivos y demencia en adultos mayores, y es considerada una nueva epidemia. Por sus diferentes manifestaciones cognitivas, conductuales y funcionales, la detección, diagnóstico y tratamiento de los pacientes con Demencia debida a Enfermedad de Alzheimer puede representar un desafío. En las presentes recomendaciones se dan pautas de manejo con niveles de recomendación basados en la mejor evidencia científica disponible. Asimismo, se presentan indicaciones y sugerencias de estudio, o derivación a un nivel superior de asistencia según la complejidad de cada caso. De este modo, se brinda un conjunto de recomendaciones prácticas de apoyo para la toma de decisiones por parte de los profesionales de la salud en cada nivel sanitario, desde la asistencia primaria hasta los médicos especialistas. Mediante un enfoque operativo y dinámico, estas Recomendaciones proponen un enfoque global basado en la evidencia para los pacien...
Vertex, 2019
Alzheimer's disease is the most frequent cause of cognitive disorders and dementia in older a... more Alzheimer's disease is the most frequent cause of cognitive disorders and dementia in older adults and is considered a new epi- demic. Due to its different cognitive, behavioral and functional manifestations, the detection, and diagnosis of patients with Alzheimer's Disease Dementia can represent a challenge. In this Clinical Practice Recommendation, management are given with levels based on the best scientific evidence available. Likewise, indications for study, or referral to a higher level of sanitary assistance are presented, according to the complexity of each clinical case. In this way, a set of practical recommendations of support is provided for decision making by health professionals at each sanitary level, from primary care to medical specialists. Through an operational and dynamic approach, this recommendations propose a global strategy based on evidence for patients, family members and health agents involved in this pathology, of great social relevance.
Fil: Demey, Ignacio. Fundacion para la Lucha contra las Enfermedades Neurologicas de la Infancia;... more Fil: Demey, Ignacio. Fundacion para la Lucha contra las Enfermedades Neurologicas de la Infancia; Argentina. Hospital Britanico de Buenos Aires; Argentina
Dementia & Neuropsychologia, 2010
Cognitive reserve is the ability to optimize performance through differential recruitment of brai... more Cognitive reserve is the ability to optimize performance through differential recruitment of brain networks, which may reflect the use of alternative cognitive strategies. Objectives: To identify factors related to cognitive reserve associated with progression from mild cognitive impairment (MCI) to degenerative dementia. Methods: A cohort of 239 subjects with MCI (age: 72.2±8.1 years, 58% women, education: 12 years) was assessed and followed for five years (2001 to 2006). Results: In the first year, 13.7% of MCI converted to dementia and 34.7% converted within three years (78.3% converted to Alzheimer's dementia). Risk factors for those who converted were education less than 12 years, MMSE score less than 27, Boston naming test score less than 51, IQ (Intelligence Quotient) less than 111, age over 75 years, lack of occupation at retirement, and presence of intrusions in memory recall (all account for 56% of the variability of conversion). Conclusions: MCI patients are a populat...
Resumen Introducción: El deterioro cognitivo leve (DCL) es un síndrome de declinación cognitiva m... more Resumen Introducción: El deterioro cognitivo leve (DCL) es un síndrome de declinación cognitiva mayor que la esperada para la edad y que no interfiere significativamente las actividades de vida diaria. Objetivos: Determinar la validez del DCL y estudiar los factores "predictores de conversión a demencia". Materiales y Métodos: Durante 3 años fue seguida una cohorte de 301 pacientes "en riesgo de demencia" (edad 72.2±8.1; 58% mujeres, escolaridad 12 años, MMSE 27/30, CDR 0,5/3), 239 cumplían criterio de DCL. Se los evaluó con un examen neuropsiquiátrico, una batería neuropsicológica, laboratorio y neuroimágenes. Resultados: Las comorbilidades más frecuentes fueron hipertensión arterial y dislipemia. En las evaluaciones realizadas predominaron los trastornos de memoria y los síntomas conductuales. El resto de los exámenes complementarios fueron normales. En el primer año rotaron a demencia el 13% y a los tres años el 40%. La mayoría de los DCL que rotaron a demencia (78%) lo hicieron hacia enfermedad de Alzheimer. Los factores de riesgo más importantes fueron: escolaridad < 12 años, MMSE < 27, denominación < 51, CI global < 111, edad > 75 años, inactividad laboral, presencia de intrusiones y antecedentes de alucinaciones. Dichos riesgos explican el 69.2% de la variabilidad de rotación. Conclusiones: Los datos presentados, los primeros reportados en nuestro medio, destacan la necesidad en medicina asistencial de admitir la existencia de este constructo. El estudio de los factores de riesgo, muchos de ellos responsables de la reserva funcional cognitiva, puede aportar evidencia para la actividad clínica y la toma de decisiones en salud pública. Palabras clave: Deterioro cognitivo leve, Enfermedad de Alzheimer, Alzheimer predemencia, factores de riesgo, factores de protección Summary Convertion predictors factors in mild cognitive impairment. Introduction: Mild Cognitive Impairment (MCI) defines a syndrome of cognitive impairment which is higher than expected for a specific age, without impact in daily activities. The conversion rate towards dementia is high. Objectives: To determinate the "predictors of conversion to dementia in MCI". Subjects and Methods: A sample of three hundred and one patients (age: 72.2±8.1 years, 58% women, parental education: 12 years, MMSE (Mini Mental State Examination) 27/30, Clinical Dementia Rating (CDR): 0,5/3), who began with cognitive or behavioral syndrome with no significant daily functional disability, was assessed with a neuropsychiatric examination, an extense neuropsychological battery, laboratory tests and neuroimaging. Results: Patients with MCI had comorbidities such as hipertension and dyslipemia. In the neuropsychological performance memory impairments prevailed, and in the neuropsychiatric assessment behavioral symptoms were found. Evolution: In the first year 13% converted towards dementia and 40% within three years (the majority transformed towards Alzheimer´s dementia). The risk factors of the ones who transformed towards Alzheimer´s dementia were parental education <12, MMSE < 27, Boston naming Test < 51, IQ (Intelligence Quotient) < 111, age > 75 years, without labor activity at the present time, presence of intrusions in memory recall, previous hallucinations (explain 69.2% of the variability of conversion). Conclusions: MCI is a "population in risk for degenerative dementia". The study of the risk factors in MCI can contribute an important evidence for the clinical activity and the decision making process of Public Health.
Neurology, 2012
Objective: To present the tools of detection, evaluation and results of the pilot study for Phase... more Objective: To present the tools of detection, evaluation and results of the pilot study for Phase 1, the study of the prevalence of mild cognitive impairment (MCI) and dementia in ≥ 65 years in an Argentinean population. Background Cross-sectional surveys are directed primarily to the study of the frequency and distribution of health events and disease. Design/Methods: The research was conducted in the city of Junin (Buenos Aires), under constant health survey by the Ministry of Health of Buenos Aires Province (Health Region III). We performed a systematic random sampling in 2 stages, city blocks (stage 1) and systematically selected houses (stage 2). As a screening tool, the Addenbrooke9s Cognitive Examination (ACE) and the Verbal Memory Battery of Signoret were used. Results: 70 blocks were surveyed using a door-to-door survey method. The area included 4704 people of which 740 were ≥ 65 years. 184 interviews were conducted. The average time of the survey was 30 minutes. The participation rate was 80%. The average age of those interviewed was 76.6 years (range 65-96), 60.3% women. 65.2% had 7 years of education. 37% of the population showed signs of cognitive impairment (17.9% presumed MCI and 19% presumed dementia). 31.4% of people with ACE under normal cutoff for MMSE had ≥ 24 (normal). The estimated prevalence of dementia in the area surveyed was 4.7% (95% CI 3.18-6.22). Conclusions: This pilot study confirms the feasibility of the design to follow the larger study. Disclosure: Dr. Allegri has nothing to disclose. Dr. Melcon has nothing to disclose. Dr. Riquelme has nothing to disclose. Dr. Bartoloni has nothing to disclose. Dr. Sarasola has nothing to disclose. Dr. Gonzalez has nothing to disclose.
The Journal of Clinical Psychiatry, 2009
Background-Mild cognitive impairment (MCI) is a transitional state between normal ageing and deme... more Background-Mild cognitive impairment (MCI) is a transitional state between normal ageing and dementia, at least for some patients. Behavioral symptoms in MCI are associated with a higher risk of dementia, but their association with dementia risk in patients without MCI is unknown. Mild Behavioral Impairment (MBI) refers to a late life syndrome with prominent psychiatric and related behavioral symptoms in the absence of prominent cognitive symptoms, which may also be a dementia prodrome. Objective-To compare MCI and MBI patients and to estimate the risk of dementia development in these two groups. Method-A consecutive series of 358 patients (239 with MCI; and 119 with MBI) presenting to an outpatient general hospital specialty clinic were followed for up to 5 years until conversion to dementia or censoring. Results-34% of MCI patients and over 70% of patients with MBI developed dementia (Logrank p=0.011). MBI patients without cognitive symptoms were more likely to develop dementia (Logrank p<0.001). MBI patients were more likely to develop dementia due to frontotemporal degeneration (FTD) as opposed to Alzheimer's dementia (AD). Conclusion-MBI appears to be a transitional state between normal ageing and dementia. MBI (specifically those without cognitive symptoms) may confer a higher risk for dementia than MCI and is likely an FTD prodrome in many cases. These findings have implications for the early detection, prevention, and treatment of patients with dementia in late life, by focusing on the emergence of new behavioral symptoms.
International Psychogeriatrics, 2006
Background: There is no previous information about economic costs of Alzheimer's disease (AD)... more Background: There is no previous information about economic costs of Alzheimer's disease (AD) in South America. The objective of this study was to evaluate the costs of AD in Argentina.Methods: Eighty community-dwelling patients, 20 institutionalized AD patients and their respective primary caregivers, and 25 healthy elderly subjects participated in this study. The cognitive and neuropsychiatric impairments and severity of dementia were assessed with the Mini-mental State Examination, Neuropsychiatric Inventory and Clinical Dementia Rating, respectively. A structured interview about health and health-care resources used during the past 3 months was administered to family caregivers. The time devoted by carers to looking after the patients and the caregiver burden (Zarit's Burden Interview) were recorded.Results: The annual direct costs of the disease increased with cognitive deterioration from US$3420.40 in mild to US$9657.60 in severe AD, and with institutionalization (US$3...
Vertex, 2021
INTRODUCTION AND OBJECTIVE The Mini-SEA is a quick and brief cognitive assessment test developed ... more INTRODUCTION AND OBJECTIVE The Mini-SEA is a quick and brief cognitive assessment test developed to study social cognition. It consists of a modified version of the faux pas Test and an emotional recognition test based on Ekman's faces. The objective of this work was to obtain the first Spanish Speaking norms for the Mini-SEA test. MATERIAL AND METHODS 64 healthy volunteers, between 35 and 80 years old, were recruited and evaluated with the Mini-SEA by specialized neuropsychologists from the Cities of Buenos Aires and La Plata, both in the Province of Buenos Aires, Argentina. RESULTS The total mean (M) of the Mini-SEA was 25 +/- 4. The M of the faux pas Score was 12.5 +/- 2.4 and the M of the Emotional Recognition Score was 12.8 +/- 1.5. The sample was divided into 4 age groups: Group 1 (<50 years), Group 2 (50-59 years), Group 3 (60-69 years) and Group 4 (more than 70 years). Differences were found in the age continuum in the Emotional Recognition score between group 1 and 4...
International Journal of Geriatric Psychiatry
Vertex, 2007
Several studies refer to the relationship between schizophrenia and cognitive dysfunctions. The m... more Several studies refer to the relationship between schizophrenia and cognitive dysfunctions. The most frequent disturbances accepted are the deficits in the executive, memory and verbal tests. However, there are few comparative data about the cognitive functioning of the different subtypes of schizophrenia. Analyze and compare the neuropsychological disturbances present in patients with paranoid and residual schizophrenia. Eleven patients with paranoid schizophrenia, eleven patients with residual schizophrenia (DSM-IV criteria), and thirty one normal subjects matched by age, educational level, and general cognitive level (Mini Mental State Examination (Folstein, 1975), were assessed with a semistructured psychiatric examination and an extensive neuropsychological battery. Significant differences were found in memory, language, and executive functions when schizophrenics were compared with normal subjects. Differences in similarities were found between paranoid and residual schizophrenics. Residual schizophrenics had more disturbances in neuropsychological tests in comparison with paranoid schizophrenics. Schizophrenics demonstrated disturbances in memory, language, executive functions and attention. Residual schizophrenics had more impairment in neuropsychological tests than paranoid schizophrenics.
Neuropsychiatric Disease and Treatment
Patients with Alzheimer's disease need assistance and supervision of their daily activities. They... more Patients with Alzheimer's disease need assistance and supervision of their daily activities. They survive for protracted periods of time, placing an extensive burden of care on the caregiver prior to the patient's death. The present study addressed the predictive value of behavior-related burden on Alzheimer's disease caregivers. Participants: 82 patients with probable Alzheimer's (73.7 ± 8.1 years), and their primary caregivers (59.6 ± 14.8 years, 81.5% women), were assessed. Methods: Cognitive impairment, neuropsychiatric symptoms, and dementia severity were assessed with Mini Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), and Clinical Dementia Rating (CDR), respectively. Caregivers were given Zarit´s Burden Interview and Carer Activity Inventory. Results: Neuropsychiatric symptoms like delusions, hallucinations, restlessness, anxiety, euphoria, disinhibition, unusual motor behavior, sleep disturbances, and appetite alterations were the best caregiver burden predictors (NPI r = 0.482, p Ͻ 0.001). No correlation with cognition, disease stage, or negative neuropsychiatric symptoms (depression and apathy) was found. Conclusion: Increased caregiver burden was related to increased levels of patient behavioral disturbance. Of these symptoms, hallucinations, unusual (motor) behavior, and abnormal behavior at nighttime were the most signifi cant. No correlation with neuropsychiatric symptoms such as apathy and depression was found. This may have relevance to appropriate interventions for caregivers.
Vertex (Buenos Aires, Argentina)
Several studies refer to the relationship between schizophrenia and cognitive dysfunctions. The m... more Several studies refer to the relationship between schizophrenia and cognitive dysfunctions. The most frequent disturbances accepted are the deficits in the executive, memory and verbal tests. However, there are few comparative data about the cognitive functioning of the different subtypes of schizophrenia. Analyze and compare the neuropsychological disturbances present in patients with paranoid and residual schizophrenia. Eleven patients with paranoid schizophrenia, eleven patients with residual schizophrenia (DSM-IV criteria), and thirty one normal subjects matched by age, educational level, and general cognitive level (Mini Mental State Examination (Folstein, 1975), were assessed with a semistructured psychiatric examination and an extensive neuropsychological battery. Significant differences were found in memory, language, and executive functions when schizophrenics were compared with normal subjects. Differences in similarities were found between paranoid and residual schizophre...
Is oxcarbazepine better than phenytoin for the treatment of dementia patients complicated with se... more Is oxcarbazepine better than phenytoin for the treatment of dementia patients complicated with secondary epilepsy? A comparative study. The prevalence of dementia rises with age and it increases the risk of seizure disorders with at least a six-fold increased risk of unprovoked seizures. Physicians face the matter of choosing an antiepileptic drug without efficacy and tolerability controlled clinical trials in
Revista de …, 2005
... de error menor que el 5%. Se utilizó el programa informático SPSS 10.0, Medcalc e ... DISCUSI... more ... de error menor que el 5%. Se utilizó el programa informático SPSS 10.0, Medcalc e ... DISCUSIÓN Este estudio evidenció dos hallazgos de importancia: La versión en español del ACE es ... para de corte en general prevalencias teóricas Sensi-Especi-5% 10% 20% 30% bilidad ...
Revista de …, 2005
... de error menor que el 5%. Se utilizó el programa informático SPSS 10.0, Medcalc e ... DISCUSI... more ... de error menor que el 5%. Se utilizó el programa informático SPSS 10.0, Medcalc e ... DISCUSIÓN Este estudio evidenció dos hallazgos de importancia: La versión en español del ACE es ... para de corte en general prevalencias teóricas Sensi-Especi-5% 10% 20% 30% bilidad ...
Neuropsychiatric disease and treatment, 2006
Patients with Alzheimer's disease need assistance and supervision of their daily activities. ... more Patients with Alzheimer's disease need assistance and supervision of their daily activities. They survive for protracted periods of time, placing an extensive burden of care on the caregiver prior to the patient's death. The present study addressed the predictive value of behavior-related burden on Alzheimer's disease caregivers. 82 patients with probable Alzheimer's (73.7 +/- 8.1 years), and their primary caregivers (59.6 +/- 14.8 years, 81.5% women), were assessed. Cognitive impairment, neuropsychiatric symptoms, and dementia severity were assessed with Mini Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), and Clinical Dementia Rating (CDR), respectively. Caregivers were given Zarit's Burden Interview and Carer Activity Inventory. Neuropsychiatric symptoms like delusions, hallucinations, restlessness, anxiety, euphoria, disinhibition, unusual motor behavior, sleep disturbances, and appetite alterations were the best caregiver burden predictors...
La Enfermedad de Alzheimer es la causa más frecuente de trastornos cognitivos y demencia en adult... more La Enfermedad de Alzheimer es la causa más frecuente de trastornos cognitivos y demencia en adultos mayores, y es considerada una nueva epidemia. Por sus diferentes manifestaciones cognitivas, conductuales y funcionales, la detección, diagnóstico y tratamiento de los pacientes con Demencia debida a Enfermedad de Alzheimer puede representar un desafío. En las presentes recomendaciones se dan pautas de manejo con niveles de recomendación basados en la mejor evidencia científica disponible. Asimismo, se presentan indicaciones y sugerencias de estudio, o derivación a un nivel superior de asistencia según la complejidad de cada caso. De este modo, se brinda un conjunto de recomendaciones prácticas de apoyo para la toma de decisiones por parte de los profesionales de la salud en cada nivel sanitario, desde la asistencia primaria hasta los médicos especialistas. Mediante un enfoque operativo y dinámico, estas Recomendaciones proponen un enfoque global basado en la evidencia para los pacien...
Vertex, 2019
Alzheimer's disease is the most frequent cause of cognitive disorders and dementia in older a... more Alzheimer's disease is the most frequent cause of cognitive disorders and dementia in older adults and is considered a new epi- demic. Due to its different cognitive, behavioral and functional manifestations, the detection, and diagnosis of patients with Alzheimer's Disease Dementia can represent a challenge. In this Clinical Practice Recommendation, management are given with levels based on the best scientific evidence available. Likewise, indications for study, or referral to a higher level of sanitary assistance are presented, according to the complexity of each clinical case. In this way, a set of practical recommendations of support is provided for decision making by health professionals at each sanitary level, from primary care to medical specialists. Through an operational and dynamic approach, this recommendations propose a global strategy based on evidence for patients, family members and health agents involved in this pathology, of great social relevance.
Fil: Demey, Ignacio. Fundacion para la Lucha contra las Enfermedades Neurologicas de la Infancia;... more Fil: Demey, Ignacio. Fundacion para la Lucha contra las Enfermedades Neurologicas de la Infancia; Argentina. Hospital Britanico de Buenos Aires; Argentina
Dementia & Neuropsychologia, 2010
Cognitive reserve is the ability to optimize performance through differential recruitment of brai... more Cognitive reserve is the ability to optimize performance through differential recruitment of brain networks, which may reflect the use of alternative cognitive strategies. Objectives: To identify factors related to cognitive reserve associated with progression from mild cognitive impairment (MCI) to degenerative dementia. Methods: A cohort of 239 subjects with MCI (age: 72.2±8.1 years, 58% women, education: 12 years) was assessed and followed for five years (2001 to 2006). Results: In the first year, 13.7% of MCI converted to dementia and 34.7% converted within three years (78.3% converted to Alzheimer's dementia). Risk factors for those who converted were education less than 12 years, MMSE score less than 27, Boston naming test score less than 51, IQ (Intelligence Quotient) less than 111, age over 75 years, lack of occupation at retirement, and presence of intrusions in memory recall (all account for 56% of the variability of conversion). Conclusions: MCI patients are a populat...
Resumen Introducción: El deterioro cognitivo leve (DCL) es un síndrome de declinación cognitiva m... more Resumen Introducción: El deterioro cognitivo leve (DCL) es un síndrome de declinación cognitiva mayor que la esperada para la edad y que no interfiere significativamente las actividades de vida diaria. Objetivos: Determinar la validez del DCL y estudiar los factores "predictores de conversión a demencia". Materiales y Métodos: Durante 3 años fue seguida una cohorte de 301 pacientes "en riesgo de demencia" (edad 72.2±8.1; 58% mujeres, escolaridad 12 años, MMSE 27/30, CDR 0,5/3), 239 cumplían criterio de DCL. Se los evaluó con un examen neuropsiquiátrico, una batería neuropsicológica, laboratorio y neuroimágenes. Resultados: Las comorbilidades más frecuentes fueron hipertensión arterial y dislipemia. En las evaluaciones realizadas predominaron los trastornos de memoria y los síntomas conductuales. El resto de los exámenes complementarios fueron normales. En el primer año rotaron a demencia el 13% y a los tres años el 40%. La mayoría de los DCL que rotaron a demencia (78%) lo hicieron hacia enfermedad de Alzheimer. Los factores de riesgo más importantes fueron: escolaridad < 12 años, MMSE < 27, denominación < 51, CI global < 111, edad > 75 años, inactividad laboral, presencia de intrusiones y antecedentes de alucinaciones. Dichos riesgos explican el 69.2% de la variabilidad de rotación. Conclusiones: Los datos presentados, los primeros reportados en nuestro medio, destacan la necesidad en medicina asistencial de admitir la existencia de este constructo. El estudio de los factores de riesgo, muchos de ellos responsables de la reserva funcional cognitiva, puede aportar evidencia para la actividad clínica y la toma de decisiones en salud pública. Palabras clave: Deterioro cognitivo leve, Enfermedad de Alzheimer, Alzheimer predemencia, factores de riesgo, factores de protección Summary Convertion predictors factors in mild cognitive impairment. Introduction: Mild Cognitive Impairment (MCI) defines a syndrome of cognitive impairment which is higher than expected for a specific age, without impact in daily activities. The conversion rate towards dementia is high. Objectives: To determinate the "predictors of conversion to dementia in MCI". Subjects and Methods: A sample of three hundred and one patients (age: 72.2±8.1 years, 58% women, parental education: 12 years, MMSE (Mini Mental State Examination) 27/30, Clinical Dementia Rating (CDR): 0,5/3), who began with cognitive or behavioral syndrome with no significant daily functional disability, was assessed with a neuropsychiatric examination, an extense neuropsychological battery, laboratory tests and neuroimaging. Results: Patients with MCI had comorbidities such as hipertension and dyslipemia. In the neuropsychological performance memory impairments prevailed, and in the neuropsychiatric assessment behavioral symptoms were found. Evolution: In the first year 13% converted towards dementia and 40% within three years (the majority transformed towards Alzheimer´s dementia). The risk factors of the ones who transformed towards Alzheimer´s dementia were parental education <12, MMSE < 27, Boston naming Test < 51, IQ (Intelligence Quotient) < 111, age > 75 years, without labor activity at the present time, presence of intrusions in memory recall, previous hallucinations (explain 69.2% of the variability of conversion). Conclusions: MCI is a "population in risk for degenerative dementia". The study of the risk factors in MCI can contribute an important evidence for the clinical activity and the decision making process of Public Health.
Neurology, 2012
Objective: To present the tools of detection, evaluation and results of the pilot study for Phase... more Objective: To present the tools of detection, evaluation and results of the pilot study for Phase 1, the study of the prevalence of mild cognitive impairment (MCI) and dementia in ≥ 65 years in an Argentinean population. Background Cross-sectional surveys are directed primarily to the study of the frequency and distribution of health events and disease. Design/Methods: The research was conducted in the city of Junin (Buenos Aires), under constant health survey by the Ministry of Health of Buenos Aires Province (Health Region III). We performed a systematic random sampling in 2 stages, city blocks (stage 1) and systematically selected houses (stage 2). As a screening tool, the Addenbrooke9s Cognitive Examination (ACE) and the Verbal Memory Battery of Signoret were used. Results: 70 blocks were surveyed using a door-to-door survey method. The area included 4704 people of which 740 were ≥ 65 years. 184 interviews were conducted. The average time of the survey was 30 minutes. The participation rate was 80%. The average age of those interviewed was 76.6 years (range 65-96), 60.3% women. 65.2% had 7 years of education. 37% of the population showed signs of cognitive impairment (17.9% presumed MCI and 19% presumed dementia). 31.4% of people with ACE under normal cutoff for MMSE had ≥ 24 (normal). The estimated prevalence of dementia in the area surveyed was 4.7% (95% CI 3.18-6.22). Conclusions: This pilot study confirms the feasibility of the design to follow the larger study. Disclosure: Dr. Allegri has nothing to disclose. Dr. Melcon has nothing to disclose. Dr. Riquelme has nothing to disclose. Dr. Bartoloni has nothing to disclose. Dr. Sarasola has nothing to disclose. Dr. Gonzalez has nothing to disclose.
The Journal of Clinical Psychiatry, 2009
Background-Mild cognitive impairment (MCI) is a transitional state between normal ageing and deme... more Background-Mild cognitive impairment (MCI) is a transitional state between normal ageing and dementia, at least for some patients. Behavioral symptoms in MCI are associated with a higher risk of dementia, but their association with dementia risk in patients without MCI is unknown. Mild Behavioral Impairment (MBI) refers to a late life syndrome with prominent psychiatric and related behavioral symptoms in the absence of prominent cognitive symptoms, which may also be a dementia prodrome. Objective-To compare MCI and MBI patients and to estimate the risk of dementia development in these two groups. Method-A consecutive series of 358 patients (239 with MCI; and 119 with MBI) presenting to an outpatient general hospital specialty clinic were followed for up to 5 years until conversion to dementia or censoring. Results-34% of MCI patients and over 70% of patients with MBI developed dementia (Logrank p=0.011). MBI patients without cognitive symptoms were more likely to develop dementia (Logrank p<0.001). MBI patients were more likely to develop dementia due to frontotemporal degeneration (FTD) as opposed to Alzheimer's dementia (AD). Conclusion-MBI appears to be a transitional state between normal ageing and dementia. MBI (specifically those without cognitive symptoms) may confer a higher risk for dementia than MCI and is likely an FTD prodrome in many cases. These findings have implications for the early detection, prevention, and treatment of patients with dementia in late life, by focusing on the emergence of new behavioral symptoms.
International Psychogeriatrics, 2006
Background: There is no previous information about economic costs of Alzheimer's disease (AD)... more Background: There is no previous information about economic costs of Alzheimer's disease (AD) in South America. The objective of this study was to evaluate the costs of AD in Argentina.Methods: Eighty community-dwelling patients, 20 institutionalized AD patients and their respective primary caregivers, and 25 healthy elderly subjects participated in this study. The cognitive and neuropsychiatric impairments and severity of dementia were assessed with the Mini-mental State Examination, Neuropsychiatric Inventory and Clinical Dementia Rating, respectively. A structured interview about health and health-care resources used during the past 3 months was administered to family caregivers. The time devoted by carers to looking after the patients and the caregiver burden (Zarit's Burden Interview) were recorded.Results: The annual direct costs of the disease increased with cognitive deterioration from US$3420.40 in mild to US$9657.60 in severe AD, and with institutionalization (US$3...
Vertex, 2021
INTRODUCTION AND OBJECTIVE The Mini-SEA is a quick and brief cognitive assessment test developed ... more INTRODUCTION AND OBJECTIVE The Mini-SEA is a quick and brief cognitive assessment test developed to study social cognition. It consists of a modified version of the faux pas Test and an emotional recognition test based on Ekman's faces. The objective of this work was to obtain the first Spanish Speaking norms for the Mini-SEA test. MATERIAL AND METHODS 64 healthy volunteers, between 35 and 80 years old, were recruited and evaluated with the Mini-SEA by specialized neuropsychologists from the Cities of Buenos Aires and La Plata, both in the Province of Buenos Aires, Argentina. RESULTS The total mean (M) of the Mini-SEA was 25 +/- 4. The M of the faux pas Score was 12.5 +/- 2.4 and the M of the Emotional Recognition Score was 12.8 +/- 1.5. The sample was divided into 4 age groups: Group 1 (<50 years), Group 2 (50-59 years), Group 3 (60-69 years) and Group 4 (more than 70 years). Differences were found in the age continuum in the Emotional Recognition score between group 1 and 4...
International Journal of Geriatric Psychiatry
Vertex, 2007
Several studies refer to the relationship between schizophrenia and cognitive dysfunctions. The m... more Several studies refer to the relationship between schizophrenia and cognitive dysfunctions. The most frequent disturbances accepted are the deficits in the executive, memory and verbal tests. However, there are few comparative data about the cognitive functioning of the different subtypes of schizophrenia. Analyze and compare the neuropsychological disturbances present in patients with paranoid and residual schizophrenia. Eleven patients with paranoid schizophrenia, eleven patients with residual schizophrenia (DSM-IV criteria), and thirty one normal subjects matched by age, educational level, and general cognitive level (Mini Mental State Examination (Folstein, 1975), were assessed with a semistructured psychiatric examination and an extensive neuropsychological battery. Significant differences were found in memory, language, and executive functions when schizophrenics were compared with normal subjects. Differences in similarities were found between paranoid and residual schizophrenics. Residual schizophrenics had more disturbances in neuropsychological tests in comparison with paranoid schizophrenics. Schizophrenics demonstrated disturbances in memory, language, executive functions and attention. Residual schizophrenics had more impairment in neuropsychological tests than paranoid schizophrenics.
Neuropsychiatric Disease and Treatment
Patients with Alzheimer's disease need assistance and supervision of their daily activities. They... more Patients with Alzheimer's disease need assistance and supervision of their daily activities. They survive for protracted periods of time, placing an extensive burden of care on the caregiver prior to the patient's death. The present study addressed the predictive value of behavior-related burden on Alzheimer's disease caregivers. Participants: 82 patients with probable Alzheimer's (73.7 ± 8.1 years), and their primary caregivers (59.6 ± 14.8 years, 81.5% women), were assessed. Methods: Cognitive impairment, neuropsychiatric symptoms, and dementia severity were assessed with Mini Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), and Clinical Dementia Rating (CDR), respectively. Caregivers were given Zarit´s Burden Interview and Carer Activity Inventory. Results: Neuropsychiatric symptoms like delusions, hallucinations, restlessness, anxiety, euphoria, disinhibition, unusual motor behavior, sleep disturbances, and appetite alterations were the best caregiver burden predictors (NPI r = 0.482, p Ͻ 0.001). No correlation with cognition, disease stage, or negative neuropsychiatric symptoms (depression and apathy) was found. Conclusion: Increased caregiver burden was related to increased levels of patient behavioral disturbance. Of these symptoms, hallucinations, unusual (motor) behavior, and abnormal behavior at nighttime were the most signifi cant. No correlation with neuropsychiatric symptoms such as apathy and depression was found. This may have relevance to appropriate interventions for caregivers.
Vertex (Buenos Aires, Argentina)
Several studies refer to the relationship between schizophrenia and cognitive dysfunctions. The m... more Several studies refer to the relationship between schizophrenia and cognitive dysfunctions. The most frequent disturbances accepted are the deficits in the executive, memory and verbal tests. However, there are few comparative data about the cognitive functioning of the different subtypes of schizophrenia. Analyze and compare the neuropsychological disturbances present in patients with paranoid and residual schizophrenia. Eleven patients with paranoid schizophrenia, eleven patients with residual schizophrenia (DSM-IV criteria), and thirty one normal subjects matched by age, educational level, and general cognitive level (Mini Mental State Examination (Folstein, 1975), were assessed with a semistructured psychiatric examination and an extensive neuropsychological battery. Significant differences were found in memory, language, and executive functions when schizophrenics were compared with normal subjects. Differences in similarities were found between paranoid and residual schizophre...
Is oxcarbazepine better than phenytoin for the treatment of dementia patients complicated with se... more Is oxcarbazepine better than phenytoin for the treatment of dementia patients complicated with secondary epilepsy? A comparative study. The prevalence of dementia rises with age and it increases the risk of seizure disorders with at least a six-fold increased risk of unprovoked seizures. Physicians face the matter of choosing an antiepileptic drug without efficacy and tolerability controlled clinical trials in
Revista de …, 2005
... de error menor que el 5%. Se utilizó el programa informático SPSS 10.0, Medcalc e ... DISCUSI... more ... de error menor que el 5%. Se utilizó el programa informático SPSS 10.0, Medcalc e ... DISCUSIÓN Este estudio evidenció dos hallazgos de importancia: La versión en español del ACE es ... para de corte en general prevalencias teóricas Sensi-Especi-5% 10% 20% 30% bilidad ...
Revista de …, 2005
... de error menor que el 5%. Se utilizó el programa informático SPSS 10.0, Medcalc e ... DISCUSI... more ... de error menor que el 5%. Se utilizó el programa informático SPSS 10.0, Medcalc e ... DISCUSIÓN Este estudio evidenció dos hallazgos de importancia: La versión en español del ACE es ... para de corte en general prevalencias teóricas Sensi-Especi-5% 10% 20% 30% bilidad ...
Neuropsychiatric disease and treatment, 2006
Patients with Alzheimer's disease need assistance and supervision of their daily activities. ... more Patients with Alzheimer's disease need assistance and supervision of their daily activities. They survive for protracted periods of time, placing an extensive burden of care on the caregiver prior to the patient's death. The present study addressed the predictive value of behavior-related burden on Alzheimer's disease caregivers. 82 patients with probable Alzheimer's (73.7 +/- 8.1 years), and their primary caregivers (59.6 +/- 14.8 years, 81.5% women), were assessed. Cognitive impairment, neuropsychiatric symptoms, and dementia severity were assessed with Mini Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), and Clinical Dementia Rating (CDR), respectively. Caregivers were given Zarit's Burden Interview and Carer Activity Inventory. Neuropsychiatric symptoms like delusions, hallucinations, restlessness, anxiety, euphoria, disinhibition, unusual motor behavior, sleep disturbances, and appetite alterations were the best caregiver burden predictors...