Patients with dementia syndrome in public and private services in southern Brazil (original) (raw)
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Dementia care in public health in Brazil and the world
2014
This study aimed to identify in the recent scientific literature, information on health care provided to people with dementia, dementia costs and its resource implications for public health. Methods: This was a systematic review of the literature in which the articles were consulted from the databases PubMed/MEDLINE, LILACS and SciELO. The review sample consisted of 45 articles. Results: Examination of the studies identified the current scenario of dementia in relation to public health and public policy in Brazil and the world. The analyzed studies revealed key information on aspects of dementia in the world. There was consensus on the high prevalence of the syndrome and on the significant cost of health care and public policy for assisting the elderly with dementia. Conclusion: The importance of planning and implementing new public policies was recognized, since these are essential for the organization and management of health services and directly influence the country's ability to provide health care for people with dementia.
ANALYSIS OF DEMENTIA MORTALITY IN BRAZIL: A RETROSPECTIVE STUDY (Atena Editora)
ANALYSIS OF DEMENTIA MORTALITY IN BRAZIL: A RETROSPECTIVE STUDY (Atena Editora), 2024
Dementia is a syndrome caused by chronic and progressive brain disease, leading to cognitive decline that affects mental functions such as memory, thinking, and language. Each person is affected in a unique way, depending on the underlying disease and individual characteristics, as well as factors such as personality and environment. Alzheimer's disease presents with progressive memory decline, while dementia with Lewy bodies includes visual hallucinations and parkinsonian signs. The diagnosis of dementia involves cognitive assessment with screening and neuropsychological tests to identify cognitive alterations and differentiate forms of dementia. The objective of the present study was to identify the epidemiological profile of dementia in Brazil. The time frame was the incidence of notifications of the disease in the period from 2017 to 2023. A quantitative, retrospective and epidemiological methodological approach was used, showing the number of hospitalizations due to dementia. The data were collected through the S.U.S. (Unified Health System) Information Technology Department (DATASUS), and the variables investigated were year of care, region, age group, gender, color/race, and deaths related to dementia. The data from this study highlight the importance of a regionalized and multidisciplinary approach to tackling dementia in Brazil. Investments in health infrastructure, training of professionals, and awareness campaigns are essential to improve the diagnosis and treatment of the disease, especially in less favored regions.
Epidemiologic Survey of Dementia in a Community-Dwelling Brazilian Population
Alzheimer Disease & Associated Disorders, 2002
The authors report the prevalence of dementia in a community-dwelling Brazilian elderly population and correlate prevalence data with educational and socioeconomic levels. The study was conducted in Catanduva, Brazil. A total of 1,656 randomly selected subjects aged 65 years or more were submitted to a health questionnaire, the Mini-Mental State Examination (MMSE), and the Pfeffer Functional Activities Questionnaire (PFAQ). According to the PFAQ and MMSE scores, selected subjects were submitted to clinical, neurologic, and cognitive evaluations. The subjects diagnosed with dementia underwent laboratory tests and brain computed tomography (CT). Dementia was diagnosed in 118 subjects, corresponding to a prevalence of 7.1%. The main clinical diagnoses were Alzheimer disease (AD; 55.1%), vascular dementia (9.3%), and AD with cerebrovascular disease (14.4%). The prevalence increased with age and was higher in women. There was an inverse association with education (3.5% among persons with 8 or more years of schooling to 12.2% among those who were illiterate). Multivariate analysis disclosed significant association between these three variables and dementia. The prevalence of dementia in this Brazilian population was 7.1%, and AD was the most frequent diagnosis. Age, female gender, and low educational level were significantly associated with a higher prevalence of dementia.
Prevalence of dementia in patients seen at a private hospital in the Southern Region of Brazil
einstein (São Paulo), 2020
Objective: To evaluate the epidemiological profile of patients seen at a dementia outpatient clinic. Methods: A retrospective study conducted by medical record review searching data on sex, race, age, schooling level, and diagnosis of patients seen from 2008 to 2015. Results: A total of 760 patients were studied, with a predominance of female (61.3%; p<0.0001). The mean age was 71.2±14.43 years for women and 66.1±16.61 years for men. The most affected age group was 71 to 80 years, accounting for 29.4% of cases. In relation to race, 96.3% of patients were white. Dementia was diagnosed in 68.8% of patients, and Alzheimer’s disease confirmed in 48.9%, vascular dementia in 11.3%, and mixed dementia in 7.8% of cases. The prevalence of dementia was 3% at 70 years and 25% at 85 years. Dementia appeared significantly earlier in males (mean age 68.5±15.63 years). As to sex distribution, it was more frequent in women (59.6%) than in men (40.4%; p<0.0001; OR=2.15). People with higher schooling level (more than 9 years) had a significantly younger age at onset of dementia as compared to those with lower schooling level (1 to 4 years; p=0.0007). Conclusion: Most patients seen in the period presented dementia, and Alzheimer was the most prevalent disease. Women were more affected, and men presented young onset of the disease. Individuals with higher schooling level were diagnosed earlier than those with lower level.
Dementia care in public health in Brazil and the world: A systematic review
Dementia & Neuropsychologia, 2014
OBJECTIVE: This study aimed to identify in the recent scientific literature, information on health care provided to people with dementia, dementia costs and its resource implications for public health. METHODS: This was a systematic review of the literature in which the articles were consulted from the databases PubMed/MEDLINE, LILACS and SciELO. The review sample consisted of 45 articles. RESULTS: Examination of the studies identified the current scenario of dementia in relation to public health and public policy in Brazil and the world. The analyzed studies revealed key information on aspects of dementia in the world. There was consensus on the high prevalence of the syndrome and on the significant cost of health care and public policy for assisting the elderly with dementia. CONCLUSION: The importance of planning and implementing new public policies was recognized, since these are essential for the organization and management of health services and directly influence the country&...
Dementia & Neuropsychologia
Patients with dementia are commonly admitted to inpatient sectors. The aim of this study was to describe the frequency of dementia among elderly inpatients admitted to the Geriatrics Sector of a Brazilian Tertiary University Hospital, and to identify associations between dementia and clinical and sociodemographic factors. Methods: All patients admitted to the Geriatrics Sector of a public Brazilian university-hospital from March 1st 2014 to January 31st 2015 were assessed by geriatricians. The patients were divided into groups "with or without diagnosis of dementia". Univariate analysis was performed between these two groups using the Chi-Square Test, Student's t-test or the Mann-Whitney Test. Results: One hundred and three elderly inpatients, with a mean age of 82 (±7.9) years, were assessed. Overall, 74.7% had low educational level (<4 years), 66% used polypharmacy, 57.2% developed delirium during hospitalization and 59% were totally dependent for basic activities...
Psychogeriatrics, 2015
BackgroundSpecific comorbidities affect older patients with dementia admitted to general hospitals and may complicate the recognition of dementia. The aim of the present study was to estimate the prevalence of dementia among elderly inpatients admitted to hospital medical wards and to identify its distribution across clinical and sociodemographic conditions.MethodsFrom June 2011 to May 2012, a sample of elderly inpatients (≥60 years old) were screened for dementia with the Mini‐Mental State Examination and the Bayer Activities of Daily Living Scale to identify cognitive and functional impairment (CFI). Subjects with CFI underwent a diagnostic procedure for dementia using the Cambridge Mental Disorders of the Elderly Examination and the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. The elderly inpatients also completed a standard questionnaire to investigate sociodemographic and clinical variables and a screening procedure for depression and delirium. The data o...
POPULATION EPIDEMIOLOGICAL STUDY OF DEMENTIA IN THE CITY OF LONDRINA - PARANÁ - BRAZIL (Atena Editora), 2022
Brazilian society has undergone an important transformation in the profile of diseases, with a broad focus on chronic-degenerative diseases, especially among elderly patients, who are increasing in number, given the increase in global life expectancy. One of the examples of these chronic pathological conditions are dementias, frames of decline in cognitive ability with related functional dyears. The current work aims to project the number of elderly people in a state of dementia, through the prevalence of Alzheimer's Disease (AD) in Londrina, based on the distribution between several factors - age, sex, level of education, type of dementia, family history in first-degree relatives, risk factors and comorbidities presented. Previous studies have shown an increase in dementia with advancing age, with a predominance in females and a slight increase in black males. Brazil presented an average above world projections, being important more studies of the causes related to dementia and also the direction of care for patients who are at greater risk of developing it. AD, as well as other dementia syndromes, are embargoes for public health because they generate patients with loss of quality of life, autonomy and independence. These factors lead to an ethical and biopsychosocial issue: the patient's deficits make him fragile, increasing the risks of psychopathological conditions and also include the responsibility of the health system and family members as a form of care for individuals with dementia. The present work was approved by the Research Ethics Committee, with a careful evaluation of medical records and selection of the same for the composition of a spreadsheet, through which the epidemiological statistical analyzes were carried out. A total of 1469 medical records were collected, with results that indicated a higher prevalence, in the places, in the female gender and greater amplitude of difference between 80 and 89 years of age. The combined prevalence of the evaluated centers was 44.70%, with Alzheimer's disease dementia being the most frequent, representing a value close to 90% of the total sample. Other analyzes were carried out, allowing a broader and more generalized observation of the specific-regional panorama of the two clinical centers observed.
Alzheimer Disease & Associated Disorders, 2007
The aim of this study was to determine the diagnostic value and agreement analyses between Clinical Dementia Rating (CDR) and dementia diagnostic criteria (gold standard), Blessed Dementia Rating scale (BDRS), and Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition, Revised (DSM III-R) criteria for severity. In a sample of 343 Southern Brazilian participants, CDR was consecutively assessed in 295 dementia patients (Alzheimer disease, vascular dementia, and questionable) and 48 healthy elderly. The National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria for probable Alzheimer disease and the National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherche´et l'Enseignement en Neurosciences (NINDS-AIREN) for probable vascular dementia were the gold standard. A battery of cognitive tests and the Mini Mental State Examination (as a screening test at study entry) were also applied. Sensitivity and specificity were obtained through contingency tables. Validity and reliability were measured through k coefficient, Kendall b, and percent agreement. CDR agreement among raters was demonstrated by percent agreement. Agreement to gold standard was good (k = 0.75), as well as to the Blessed scale (k = 0.73), and excellent to the DSM III-R (k = 0.78). CDR detection of dementia among healthy elderly or questionable dementia was 86% and 80% sensitive, respectively, and 100% specific for both settings. In conclusion, agreement of CDR global score with the gold standard was good, and diagnostic values were high.