Demencias. ¿Qué hacemos hoy y qué podríamos hacer? Análisis de una cohorte en el mundo real de pacientes con trastornos cognitivos y conductuales

Introduction and objectives

Dementia (D) are presented with high prevalence in older adults with great personal and socioeconomic impact. The objective of this study was to determine in patients, from the real world, who consulted for cognitive behavioral disorders (CBD), the diagnostic conditions and the therapeutic measures before and after the evaluation.

Material and method

Naturalistic horizontal study that included patients who made their first consultation for CBD in a reference center in Mendoza, Argentina.

Results

A total of 135 patients were included, mean age 76 years. A definite CBD was diagnosed in 124 patients (92%). The 48% corresponded to Alzheimer's (AD), 23% Mild Neurocognitive Disorder, 12% D. Mixed, 8% D. Lewy (DL), 3% D. Frontotemporal (DFT) and 6% other impairments. 115 patients had one or more previous consultations for CBB (ULT), the rest did so for the first time (PV). In the ULT group, 74% were evaluated by primary care physicians (general or family). The presence of D/TCM is related to older age (76/69 years P=.009) and duration of symptoms (2.6/1.4 years P=.014). 29% of ULT patients had undergone routine laboratory and 56% neuroimaging. Vitamin B₁₂ (D-B₁₂) deficiency was detected in 21%. Regarding the previous diagnosis: 48% did not have a definite diagnosis, 26% reported diagnoses such as senility, Senile D, atherosclerosis, age-related D, etc. In the group of treatable D. 37% did not receive any type of medication, 16% received medications without any degree of recommendation for use, 40% were taking memantine (20% optimal doses), 23% an anticholinesterases drugs (10% optimal doses), 15% were on combination therapy and of them only 5% in effective doses. 20% of the total group had been indicated, mentioned and/or performed regular physical activity, 17% cognitive stimulation and 14% healthy diet.

Conclusions

It is imperative to implement energetic and sustained educational measures to disseminate diagnostic and therapeutic algorithms for the correct management of CBD. These should include the use of non-pharmacological therapies, also around prevention. This will optimize and homogenize the comprehensive management of these devastating diseases.