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Towards a better characterization of dementia in northeast Brazil: Numbers from a reference center in Recife
Author(s) -
Mota Andreia Braga,
Lins Maria Eduarda Pires,
Lima Silva,
de Oliveira Xavier Ramos Julia,
Souza Ana Rita,
Zacarias Bruno Felipe Vieira,
Ramos Bruno,
da Silva Rodrigo Cavalcanti Machado,
Brandao Simone Cristina Soares,
Barbosa Breno José Alencar Pires
Publication year - 2021
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.056613
Subject(s) - dementia , medicine , population , descriptive statistics , neuroimaging , neuropsychology , gerontology , metropolitan area , psychiatry , disease , cognition , environmental health , pathology , statistics , mathematics
Background dementia numbers are increasing rapidly with a substantial contribution from low and middle‐income countries. There’s a limited number of reports in Brazil, mostly modest initiatives from south‐eastern, more developed areas, such as the Tremembe study which reported a 17,5% prevalence of dementia in 630 elderly subjects. With a population of approx. million individuals, the metropolitan region of Recife is among the largest cities of Northeast Brazil, a region of profound social disparities and high prevalence of low‐literacy. Method this is a single‐center, descriptive and health records‐based analysis of patients evaluated in the Dementia outpatient clinic of the Neurology and Neurosurgery Unit at the Federal University of Pernambuco in the timeframe between 2018 ‐ 2019. Result 60 patients had their data available and were included for descriptive analysis. Mean age was 69 years old (+ 7.6 SD) with 62% of women and 6 years of formal education. 46% of all cases were referred for evaluation from neighboring cities and states. The mean Mini‐mental state examination in the first consultation was 15/30 and patients had a significant burden of functional impairment with a mean Pfeffer score of 21/30 (+ 9.8 SD). Hypertension (40%), Diabetes (71%) and Anxiety (85%) were frequent comorbidities. Regarding access to neuroimaging methods, 75% subjects had access to either CT (16/60) or MRI (39/60) and 12 individuals were further evaluated with molecular neuroimaging (SPECT and/or FDG‐PET). Formal neuropsychological evaluation, CSF biomarkers and advanced amyloid/tau imaging were not available. Alzheimer’s dementia was diagnosed in 45% individuals and another 45% had criteria for mixed vascular and degenerative conditions. 18% presented with other neurodegenerative syndromes such as FTD and Lewy bodies dementia. The mean follow up time in our service was of 19.8 months. Conclusion patients referred for evaluation were mostly in moderate to advanced stages of dementia, with a significant prevalence of mixed‐type and non‐Alzheimer’s pathologies. This data could suggest a referral bias and poor access to specialized clinics. Despite a modest sample size and heterogeneous data, the present study may contribute towards a better characterization of dementia numbers in Northeast Brazil.